We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • Psc 17

Get Psc 17

PEDIATRIC SYMPTOM CHECKLIST 17 (PSC17) Name: DOB: Date: Historian: Relationship to Patient: NEVER 1. Fidgety, unable to sit still 2. Feels sad, unhappy 3. Daydreams too much 4. Refuses to share 5.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the Psc 17 online

The Pediatric Symptom Checklist 17 (PSC-17) is a valuable tool for assessing children's emotional and behavioral health. This guide provides clear, step-by-step instructions for completing the PSC-17 form online to ensure accurate and thorough responses.

Follow the steps to successfully complete the PSC-17 online.

  1. Click 'Get Form' button to obtain the PSC-17 form and open it in your editor.
  2. Fill in the patient’s name, date of birth, and the current date in the designated fields. These details help personalize the form and enable easier tracking of responses.
  3. Identify the historian, who is providing information about the patient. Input their name and relationship to the patient in the appropriate sections.
  4. Review the list of 17 statements related to the child’s symptoms and behaviors. Evaluate how frequently each statement applies to the child by selecting one of the options—'Never', 'Sometimes', or 'Often'—for each item.
  5. Once all questions have been addressed, ensure all sections of the form are complete and accurate. This is crucial for obtaining reliable feedback regarding the child's health.
  6. After verifying the information, save your changes. You should have options to download, print, or share the completed form as needed.

Begin completing your PSC-17 online today for a comprehensive evaluation of your child's well-being.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

What is the PSC–17? The Pediatric Symptom...
What is the PSC–17? The Pediatric Symptom Checklist (PSC) is brief screening...
Learn more
Pediatric Symptom Checklist-17 (PSC-17)
13. Pediatric Symptom Checklist-17 (PSC-17). Caregiver Completing this Form: ... The brief...
Learn more
hp psc 2100 series all-in-one - Laptop Computers...
17 hp psc 2100 series. The circle moves to the left or right, depending on the button you...
Learn more

Related links form

United India Claim for Health Insurance Policies - Part A UTI Mutual Fund Distributor Empanelment Form Jamaica Form 1B JM CSD-AMD15-14-J01 2014

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

The Pediatric Symptom Checklist (PSC) is a brief screening questionnaire used by pediatricians and other health professionals to recognize psychosocial problems and improve treatment in children.

Understanding the PSC Report Ages 6-16: A score of 28 or higher means that he/she has more problems than most other children of that age. Most children in this group with a score of 28 or higher would benefit from further assessment of their psychosocial functioning.

Who completes the PSC-17? The checklist is completed by the biological, adoptive, or foster parent, or guardian on behalf of the child.

What is the PSC–17? The Pediatric Symptom Checklist (PSC) is brief screening questionnaire that is used to improve the recognition and treatment of psychosocial problems in children ages 4 to 17 years. It is used in place of the PHQ-9 for Health Home beneficiaries within this age group.

The PSC-17 consists of 17 items that are rated as “Never,” “Sometimes, ” or “Often” present. A value of 0 is assigned to “Never”, 1 to “Sometimes,” and 2 to “Often”. The total score is calculated by adding together the score for each of the 17 items. Items that are left blank are simply ignored (i.e., score equals 0).

A total PSC-17 score of 15 or higher suggests the presence of significant behavioural or emotional problems requiring comprehensive assessment. There are also cutoff scores for three subscales that suggest a more comprehensive assessment is advisable: Internalising Subscale (Clinical cutoff = 5 or higher).

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Psc 17
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232