Begin with your story.
Health, experiences, relationships, and strengths all belong in the conversation.
Move through short sections. Follow-up questions appear only when relevant.
Review your responses and create a narrative to discuss with your clinician.
Edit the narrative and download a Word-compatible document.
Responses stay in this page’s memory and disappear if you refresh or close it. You can deliberately download a draft and load it later. Downloaded files contain sensitive information; keep them in an approved secure location.
This form is not monitored. If you are in immediate danger, contact local emergency services or someone who can help you stay safe. It does not replace a clinical interview, risk assessment, or diagnosis.
Adolescents: complete this with your clinician’s guidance. Consent, assent, guardian access, and privacy limits must be handled by your provider.
An original More Than Therapy tool. Inspired by the workflow described by NBFE; not affiliated with NBFE and does not reproduce its questionnaire.
Review & narrative
A starting point for a conversation. Review the source responses, then edit the draft.
Editable narrative
Regenerating replaces your edits after confirmation. Downloads use the text currently in this editor.
Notes are appended to exported reports. Completion does not represent a clinical signature or approval.
About this tool & clinical scope
Original questions organized around health, psychological history, functioning, social context, culture, and strengths. Domains are informed by SAMHSA TIP 42, Chapter 3 (2020). This is an unvalidated information-gathering form, not a standardized test or comprehensive forensic evaluation.
For remote clinical use, the practice must implement an approved secure submission and record workflow, appropriate vendor agreements, access controls, consent and emergency procedures. This review version has no remote submission, notifications, or clinician monitoring.
Original NBFE product description