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Form Details

• Form Properties
  1. Form Title: C-SSRS Clinical Practice Screener v2
  2. Start from an Existing Form – Yes, if there is a previous version signed and locked
  3. Copyrighted Form – Yes, Copyright © 2008 The Research Foundation for Mental Hygiene, Inc.
  4. Billable Progress Note – No
  5. Have multiple versions open at same time – No
  6. Open Blank on new version – No
• Required Fields – Yes
• Lookup Tables – None
• Pre-Fill Logic – None
• Fill to Logic – None
• Signatures
  1. Staff Signature
     • Sig Type: Staff Member
     • Route To function
     • Signature locks the form

Questions 1 - 3 Tab

1. Indicate YES or NO per client answers to the specified questions.
   • Questions 1 & 2 are required.

Questions 4 - 6 Tab

1. Continue to indicate YES or NO per client answers to the specified questions.
   • Question 6 is required.

Signature Tab

Signature Credentials (see Credentials)

1. Staff Signature
   1. Sig Type: Staff Member
   2. Route To function
   3. Signature locks the form

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