Digital DASS-21 questionnaire

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Free template

Digital DASS-21 questionnaire

Send the DASS-21 questionnaire digitally to your patients. With Coflow, they answer on their phone or computer before their appointment, with no app and no login.

Each scale is scored the moment they submit. The depression, anxiety and stress scores are waiting for you on the task, and responses write back to your practice management system.

Stored in Australia
No patient app or login
Scored automatically
Writes back to your PMS

Try the digital DASS-21

Coflow forms are flexible and mobile responsive. Patients fill it in on any phone or computer, with no app and no login. Scored forms are scored automatically when the patient submits.

dass-21.pdfPage 1 of 2

DASS-21

Preview only. Nothing you choose is saved or sent.

DASS-21

Please read each statement and choose the answer which indicates how much the statement applied to you over the past week. There are no right or wrong answers. Do not spend too much time on any statement.

I found it hard to wind down
I was aware of dryness of my mouth
I couldn't seem to experience any positive feeling at all
I experienced breathing difficulty (eg, excessively rapid breathing, breathlessness in the absence of physical exertion)
I found it difficult to work up the initiative to do things
I tended to over-react to situations
I experienced trembling (eg, in the hands)
I felt that I was using a lot of nervous energy
I was worried about situations in which I might panic and make a fool of myself
I felt that I had nothing to look forward to
I found myself getting agitated
I found it difficult to relax
I felt down-hearted and blue
I was intolerant of anything that kept me from getting on with what I was doing
I felt I was close to panic
I was unable to become enthusiastic about anything
I felt I wasn't worth much as a person
I felt that I was rather touchy
I was aware of the action of my heart in the absence of physical exertion (eg, sense of heart rate increase, heart missing a beat)
I felt scared without any good reason
I felt that life was meaningless

Send the DASS-21 digitally

Patients answer on their phone or computer before they arrive, with no app or login. Coflow sends a reminder if they don’t finish, scores it the moment they submit, and files it into your PMS.

  • Scored automatically
  • Automatic reminders
  • Writes back to your PMS
Book a demo

We’ll show you the DASS-21 in Coflow and set it up with you.

Start with the free PDF

We’ll email you the printable DASS-21 and its scoring guide, plus a few ideas for moving your questionnaires online when you’re ready.

Form title

Writes back to
  • Gentu
  • MediRecords
  • Halaxy
  • and more: Nookal and Cliniko

Ready to send your forms digitally?

Book a demo and we’ll show you how Coflow sends forms by SMS or email, collects e-signatures and files answers into your practice management software.