Prescreening Instructions
Please read carefully before completing this prescreener.
This brief questionnaire helps determine whether SHIELD Psychiatry is the right clinical fit for you or your child. Our practice specializes in ADHD, anxiety, depression, and sleep disorders for patients ages 5–25.
Who Should Complete This Form
Ages 5–17: A parent or legal guardian must complete this prescreener. All responses should reflect your child’s symptoms, history, and functioning.
Ages 18–25: The patient may complete this prescreener independently. All responses should reflect your own experiences and symptoms.
How to Complete This Prescreener
- Answer each question using YES or NO based on the patient’s history
- Provide accurate and honest responses to ensure appropriate care matching
- If unsure, select the answer that best reflects your current understanding
- This prescreener takes approximately 2–3 minutes to complete
Important: This prescreener is not intended for crisis situations.
If there are urgent safety concerns, please call 911, contact 988, or go to the nearest emergency department.