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CDP Patient Forms

Please note: These forms and handouts are intended for use as one part of a course of psychotherapy treatment under the direction of a qualified mental health professional.
If you are a provider and would like to suggest an additional form or handout, please complete the form here. If you have any other questions or feedback, click here. We plan to add forms and handouts regularly, so check back often.

General Telehealth Forms

1 Telehealth Patient Checklist A fillable checklist to help patients prepare for and get the most out of their telehealth sessions.

Outcome Measures

1 PCL-5 self-scoring (XLS) This version of the PCL-5 automatically scores the scale. 
2 PCL-5 self-scoring (PDF) This version of the PCL-5 automatically scores the scale. 
3 PHQ-9 self-scoring (XLS) This version of the PHQ-9 automatically scores the scale.
4 PHQ-9 (PDF) This version of the PHQ-9 automatically scores the scale.
5 GAD-7 self scoring (XLS) This version of the GAD-7 automatically scores the scale.
6 GAD-7 self scoring (PDF) This version of the GAD-7 automatically scores the scale.
7 ISI self-scoring (XLS) This version of the ISI automatically scores the scale.
8 ISI self-scoring (PDF) This version of the ISI automatically scores the scale.
9 CSSRS (PDF) This is a fillable PDF version of the Columbia Suicide Severity Rating Scale.
10 AUDIT-C (PDF) This fillable PDF version of the AUDIT automatically scores the scale.
11 AUDIT-10 (PDF) This fillable PDF version of the 10-item version of the AUDIT automatically scores the scale.
12 DAST-10 (PDF) This fillable PDF version of the DAST-10 automatically scores the scale.
13 HIT-6 (PDF) This fillable PDF version of the HIT-6 automatically scores the scale.

Basics of CBT

1 Alternate ABC Sheet - Fillable This is a fillable ABC worksheet used to challenge thinking patterns.
2 3-Column Thought Record (Blank)  Fillable PDF version of a 3-column thought record. Can be printed.
3 5-Column Thought Record (Blank) Fillable PDF version of a 5-column thought record. Can be printed.
4 Problem-solving worksheet (Example) PDF handout of a  Problem-solving worksheet.
5 Problem-solving worksheet (Blank) Fillable PDF worksheet for using the downward arrow technique. Can be printed.

Depression Forms

1

5-Column Though Record (Example-Depression)

Example completed 5-Column thought record for a person with depression.
2 Example: 3-Column-ABC Sheet (Depression) Example completed 3-Column thought record for a person with depression.
3 Daily Depression Log and Progress Chart (XLS) Easy to use log for recording daily mood ratings. Automatically scores and graphs weekly averages. Excel document.
4 Daily Depression Log and Progress Chart (PDF) Printable PDF log for recording daily mood ratings. Has a progress chart for graphing weekly average ratings.
5 Secondary Problems That Increase Depression (PDF) Brief information handout covering how depressive symptoms can cause additional problems (Depressive cycles) which worsen depression. Provides advice for breaking the cycles.

PTSD Forms

1 5-Column Thought Record (Example-PTSD From Combat) Example completed 5-Column thought record for a person with PTSD from combat.
2 In-Vivo Hierarchy (fillable) Tracking sheet for recording changes in SUDS ratings over time while doing Prolonged Exposure.
3 PE Homework Session 1 (fillable) Prolonged Exposure homework checklist and educational handout for Session 1. Fillable PDF that can also be printed.
4 PE Homework Session 2 (fillable) Prolonged Exposure homework checklist and educational handout for Session 2. Fillable PDF that can also be printed.
5 PE Homework Session 3 (fillable) Prolonged Exposure homework checklist and educational handout for Session 3. Fillable PDF that can also be printed.
6 Managing Guilt in Combat-related PTSD Patient education handout on guilt related to combat and war, listing management strategies.

Sleep Disorders Forms

1 5-Column Thought Record (Example-Insomnia) Example completed 5-Column thought record for a person with insomnia.
2 2-Week Sleep Diary (PDF) Printable 2-week Sleep Diary, shade in boxes to represent sleep.
3 Sleep Hygiene Guidelines (PDF) Basic instructions for maintaining good sleep hygiene.
4 FAQs About Stimulus Control (PDF) Basic instructions for stimulus control.
5 Morningness/Eveningness Questionnaire (MEQ) Printable PDF version of the Morningness-Eveningness Questionnaire. Not self-scoring.
6 FAQs about Stimulus Control (PDF) Printable PDF version of the Sleep Need Questionnaire. Not self-scoring.
7 Dysfunctional Beliefs About Sleep (PDF autoscoring) Fillable PDF version of the DBAS, which automatically scores the measure. 
8 Epworth Sleepiness Scale (PDF autoscoring) Fillable PDF version of the ESS, which automatically scores the measure.
9 Sleep Disorders Interview (Fillable PDF) Fillable PDF version of the Sleep Disorders Interview

Anxiety Disorders Forms

1 Daily Anxiety Log and Progress Chart (PDF) Printable PDF log for recording daily mood ratings. Has a progress chart for graphing weekly average ratings.
2 Daily Anxiety Log and Progress Chart (XLS) Easy-to-use log for recording daily mood ratings. Automatically scores and graphs weekly averages. Excel document.
3 Exposure hierarchy form (Blank) Blank exposure hierarchy form. Fillable PDF that can also be printed.
4 Exposure practice tracking form (Example-Crowds) PDF handout of a completed hierarchy form.
5 Exposure practice tracking form (Blank) PDF handout of a completed hierarchy form.
6 Exposure hierarchy (Example-Crowds) Example completed exposure hierarchy form (fear of crowds).
7 Symptoms of a panic attack & hyperventilation  Patient education handout on panic attacks, why they happen and the role of hyperventilation in worsening panic.
CDP Patient Forms | Center for Deployment Psychology

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