Use our readymade template to create your DAST screening tool for drug abuse
Create your care assessments
DAST score | Diagnosis | Proposed treatment |
---|---|---|
0-5 | No substance use disorders | May not need treatment |
6-11 | Screen for substance use disorders | Consider counseling |
12-28 | Definitely a substance abuse problem | Active treatment |
- Prebuilt template with DAST scoring to assess the presence of drug abuse and measure its severity
- 28-item questionnaire that scores each of the 28 DSM-IV criteria as “Yes” (1 point) or “No” (0 point)
- Real-time calculation of DAST Score and diagnosis based on the form responses
- Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
- Compare the scores from the initial screening with that of the followup to track the progression of drug abuse
- Easily create responsive forms that allow patients to complete their assessments on any device at any time
Collect responses from your patients
Patient ID | 1004 |
Patient Name | John W |
Patient Email | johnw@ymail.com |
Patient Phone Number | 0987654321 |
Doctor's Name | Dr. Smith |
Location | New York |
Please select an answer for every question | |
1. Have you used drugs other than those required for medical reasons? | Yes |
2. Have you abused prescription drugs? | No |
3. Do you abuse more than one drug at a time? | Yes |
4. Can you get through the week without using drugs (other than those required for medical reasons)? | No |
5. Are you always able to stop using drugs when you want to? | Yes |
6. Do you abuse drugs on a continuous basis? | No |
7. Do you try to limit your drug use to certain situations? | Yes |
8. Have you had “blackouts” or “flashbacks” as a result of drug use? | No |
9. Do you ever feel bad about your drug abuse? | Yes |
10. Does your spouse (or parents) ever complain about your involvement with drugs? | No |
11. Do your friends or relatives know or suspect you abuse drugs? | Yes |
12. Has drug abuse ever created problems between you and your spouse? | No |
13. Has any family member ever sought help for problems related to your drug use? | Yes |
14. Have you ever lost friends because of your use of drugs? | No |
15. Have you ever neglected your family or missed work because of your use of drugs? | Yes |
16. Have you ever been in trouble at work because of drug abuse? | No |
17. Have you ever lost a job because of drug abuse? | Yes |
18. Have you gotten into fights when under the influence of drugs? | No |
19. Have you ever been arrested because of unusual behavior while under the influence of drugs? | Yes |
20. Have you ever been arrested for driving while under the influence of drugs? | No |
21. Have you engaged in illegal activities in order to obtain drug? | Yes |
22. Have you ever been arrested for possession of illegal drugs? | No |
23. Have you ever experienced withdrawal symptoms as a result of heavy drug intake? | Yes |
24. Have you had medical problems as a result of your drug use (e.g., memory loss, hepatitis, convulsions, bleeding, etc.)? | No |
25. Have you ever gone to anyone for help for a drug problem? | Yes |
26. Have you ever been in a hospital for medical problems related to your drug use? | No |
27. Have you ever been involved in a treatment program specifically related to drug use? | Yes |
28. Have you been treated as an outpatient for problems related to drug abuse? | No |
DAST Score | 16 |
Diagnosis | Screen for substance use disorders |
- Pre-populate patient details such as patient id, name, email etc in the DAST assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their DAST assessment form prior to their visit
- Allow patients to save their progress and complete their DAST assessment form at a later time without losing any responses
- Set up an email template for your DAST assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their DAST score, diagnosis, next steps when they submit their DAST assessment
Track patient responses in Google Sheets
- Export patient responses including the calculated DAST score and diagnosis to Google Sheets for easy record-keeping
- Export individual points for 28 DSM-IV criteria to Google Sheets for data manipulation and analysis for comprehensive insights
- Use pre-built reports to easily keep track of patient progress over time and monitor changes in their drug abuse symptoms
- Receive a copy of the response and the calculated DAST score by email whenever a patient submits their DAST assessment
- Use data in Google Sheets to integrate with external EHR systems for seamless data transfer
HIPAA compliance
Patient ID: | 1004 |
Patient Name: | ****** |
Patient Email: | ****** |
Patient Phone Number: | ****** |
Doctor's Name: | Dr. Smith |
Location: | New York |
Please select an answer for every question | |
1. Have you used drugs other than those required for medical reasons?: | Yes |
2. Have you abused prescription drugs?: | No |
3. Do you abuse more than one drug at a time?: | Yes |
4. Can you get through the week without using drugs (other than those required for medical reasons)?: | No |
5. Are you always able to stop using drugs when you want to?: | Yes |
6. Do you abuse drugs on a continuous basis?: | No |
7. Do you try to limit your drug use to certain situations?: | Yes |
8. Have you had “blackouts” or “flashbacks” as a result of drug use?: | No |
9. Do you ever feel bad about your drug abuse?: | Yes |
10. Does your spouse (or parents) ever complain about your involvement with drugs?: | No |
11. Do your friends or relatives know or suspect you abuse drugs?: | Yes |
12. Has drug abuse ever created problems between you and your spouse?: | No |
13. Has any family member ever sought help for problems related to your drug use?: | Yes |
14. Have you ever lost friends because of your use of drugs?: | No |
15. Have you ever neglected your family or missed work because of your use of drugs?: | Yes |
16. Have you ever been in trouble at work because of drug abuse?: | No |
17. Have you ever lost a job because of drug abuse?: | Yes |
18. Have you gotten into fights when under the influence of drugs?: | No |
19. Have you ever been arrested because of unusual behavior while under the influence of drugs?: | Yes |
20. Have you ever been arrested for driving while under the influence of drugs?: | No |
21. Have you engaged in illegal activities in order to obtain drug?: | Yes |
22. Have you ever been arrested for possession of illegal drugs?: | No |
23. Have you ever experienced withdrawal symptoms as a result of heavy drug intake?: | Yes |
24. Have you had medical problems as a result of your drug use (e.g., memory loss, hepatitis, convulsions, bleeding, etc.)?: | No |
25. Have you ever gone to anyone for help for a drug problem?: | Yes |
26. Have you ever been in a hospital for medical problems related to your drug use?: | No |
27. Have you ever been involved in a treatment program specifically related to drug use?: | Yes |
28. Have you been treated as an outpatient for problems related to drug abuse?: | No |
DAST Score: | 16 |
Diagnosis: | Screen for substance use disorders |
DAST Score: | 16 |
Diagnosis: | Screen for substance use disorders |
- Create a HIPAA compliant DAST assessment form to safely collect, store and access patient responses
- Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
- Automatically mask PHI fields when exporting DAST form responses to Google Sheets and sending them on email
- Prepopulate patient details in DAST assessments by creating secure prefill links without exposing PHI
- Limit access to patient data only for authorized personnel and minimize the risk of data breaches
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