Modified Simple Screening Instrument for Substance Abuse MSSI-SA Scoring Sheet Name/ID No Date Place/Location Name of Clinician Completing Screen Items 1 and 15 are not scored. The following items are scored as 1 yes or 0 no 2 7 3 8 4 9 5 any items listed 10 16 11 Total score Score range 0-14 Preliminary interpretation of responses Score Degree of Risk for Substance Abuse 0-1.
Loading
Open form follow the instructions
Easily sign the form with your finger
Send filled & signed form or save
How to fill out the Mssi Sa Printable online
The Modified Simple Screening Instrument for Substance Abuse (MSSI-SA) is a valuable tool for assessing risk levels associated with substance abuse. This guide will walk you through the process of filling out the MSSI-SA Printable form online, ensuring a smooth and accurate completion.
Follow the steps to successfully complete the MSSI-SA form
- Click ‘Get Form’ button to access the MSSI-SA Printable form and open it in your PDF editor.
- Begin by entering the name and identification number in the designated fields. Ensure accuracy, as this information is critical for record-keeping and analysis.
- Next, record the date of assessment in the appropriate field. This helps identify when the screening was completed.
- Provide the place or location where the screening is being conducted. This information aids in understanding the context of the assessment.
- In the section for the clinician's name, input the name of the professional completing the screening. This is important for validation and follow-up purposes.
- Items 1 and 15 are not scored, so you can skip these. For the remaining items (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 16) mark each as either 1 (yes) or 0 (no) according to the individual's responses.
- Once all relevant items are scored, calculate the total score and write it in the designated space. The score will help determine the degree of risk for substance abuse.
- Refer to the preliminary interpretation of responses to assess the risk level based on the total score entered. This classification helps guide further actions if needed.
- Finally, review all the information for accuracy. Save changes, download a copy of the filled-out form, and print or share it as required.
Start filling out the MSSI-SA Printable form online today to support your assessment needs.
Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Related content
Modified Simple Screening Instrument for Substance Abuse (MSSI-SA). Self-Administered...
the SERs) and recommendations of the USPSTF in print and on the Web. ... Major Depressive...
The National Bureau of Investigation (Filipino: Pambansang Kawanihan ng Pagsisiyasat...
Get answers to your most pressing questions about US Legal Forms API.
What is the A2 substance use assessment?
The Adolescent SASSI-A2 is designed to identify individuals who have a high probability of having a substance use disorder, including both substance abuse and substance dependence, with its decision rules yielding an overall accuracy of 94 percent.
What is the modified simple screening instrument for substance abuse?
The Modified Simple Screening Instrument for Substance Abuse (MSSI-SA) can be used to screen for alcohol and drug dependence, including prescription and over-the-counter medicines.
What are the 4 P's of substance abuse?
Screening tool that identifies alcohol, drug use and substance-related driving risk among adolescents and young adults. Parents, Partners, Past and Pregnancy (The 4Ps) Screening tool developed to detect dug, alcohol, and tobacco use among pregnant women and women of childbearing age.
What screening tool is used to detect problematic substance use that may require either a brief intervention or referral to treatment?
Overview. Screening, Brief Intervention and Referral to Treatment (SBIRT) is an evidence-based approach to identify individuals who use alcohol and other drugs (substances) at risky levels. SBIRT has been shown to be valid and reliable in identifying and improving outcomes for people who use substances.
What is the simple screening instrument for substance abuse?
Modified Simple Screening Instrument for Substance Abuse (MSSI-SA) The Modified Simple Screening Instrument for Substance Abuse (MSSI-SA) can be used to screen for alcohol and drug dependence, including prescription and over-the-counter medicines.
What is the CRAFFT screening tool used for?
The CRAFFT is a series of 6 questions developed to screen adolescents for high-risk alcohol and other drug use disorders simultaneously.
What is screening tool to brief intervention?
This screening tool consists of frequency of use questions to categorize substance use by adolescent patients into different risk categories. The accompanying resources assist clinicians in providing patient feedback and resources for follow-up.
What is the screening tool used to detect problematic substance use?
DRUG ABUSE SCREENING TEST (DAST) The DAST-10 (Drug Abuse Screening Test-10) is the shortened and more commonly used version of a 20-item (DAST-20) or the original 28-item version. The DAST is sometimes combined with the AUDIT or other alcohol screens to cover both alcohol- and drug-related problems.
Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
If you believe that this page should be taken down, please follow our DMCA take down process here.