Health Anxiety Inventory
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Use our readymade template to create your Health Anxiety Inventory (HAI-18) screening tool for health anxiety

Create your care assessments

HAI-18 score Anxiety Severity Proposed treatment
0-18 Low May not need treatment
19-36 Moderate Consider counseling
37-54 High Active treatment
  • navigate_next Prebuilt template with HAI-18 scoring to assess the presence of health anxiety and measure its severity
  • navigate_next 18-item questionnaire that scores each of the 18 criteria as “0” (not at all) to “3” (always)
  • navigate_next Real-time calculation of HAI-18 Score and anxiety severity based on the form responses
  • navigate_next Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
  • navigate_next Compare the scores from the initial screening with that of the followup to track the progression of health anxiety
  • navigate_next Easily create responsive forms that allow patients to complete their assessments on any device at any time

Collect responses from your patients

Patient ID 1004
Patient Name John W
Patient Email johnw@ymail.com
Patient Phone Number 0987654321
Doctor's Name Dr. Smith
Location New York
1 I spend much of my time worrying about my health
2 I notice aches/pains more than most other people of my age
3 I am often aware of bodily sensations or changes.
4 I try to resist thoughts of illness but am often unable to do so.
5 I am often afraid that I have a serious illness
6 I frequently have images of myself being ill.
7 I often have difficulty in taking my mind off thoughts about my health.
8 I am initially relieved but the worries always return later.
9 If I hear about an illness I often think I have it myself.
10 If I have a bodily sensation or change I always wonder what it means.
11 I usually feel at moderate risk of developing a serious illness.
12 I often think I have a serious illness.
13 If I notice an unexplained bodily sensation, I often find it difficult to think about other things.
14 My family/friends would say I worry too much about my health.
15 If I had a serious illness, I would still be able to enjoy things in my life a little.
16 If I developed a serious illness there is a moderate chance that modern medicine would be able to cure me.
17 A serious illness would ruin many aspects of my life.
18 If I had a serious illness I would feel that I had lost quite a lot of my dignity.
Health Anxiety 45
Negative Consequences 8
Total score 53
  • navigate_next Pre-populate patient details such as patient id, name, email etc in the HAI-18 assessment form before sharing it with the patients
  • navigate_next Send an email invitation with a secure link for patients to complete their HAI-18 assessment form prior to their visit
  • navigate_next Allow patients to save their progress and complete their HAI-18 assessment form at a later time without losing any responses
  • navigate_next Set up an email template for your HAI-18 assessment and automatically send invitation emails to multiple patients with ease
  • navigate_next Send a confirmation email to the patients with their HAI-18 score, diagnosis, next steps when they submit their HAI-18 assessment

Track patient responses in Google Sheets

A B C D E
1 Name Question Answer Score Total Score
2 John W 1 I spend much of my time worrying about my health 2 53
3 John W 2 I notice aches/pains more than most other people of my age 2 53
4 John W 3 I am often aware of bodily sensations or changes. 2 53
5 John W 4 I try to resist thoughts of illness but am often unable to do so. 2 53
6 John W 5 I am often afraid that I have a serious illness 2 53
7 John W 6 I frequently have images of myself being ill. 2 53
8 John W 7 I often have difficulty in taking my mind off thoughts about my health. 2 53
9 John W 8 I am initially relieved but the worries always return later. 2 53
10 John W 9 If I hear about an illness I often think I have it myself. 2 53
11 John W 10 If I have a bodily sensation or change I always wonder what it means. 2 53
12 John W 11 I usually feel at moderate risk of developing a serious illness. 2 53
13 John W 12 I often think I have a serious illness. 2 53
14 John W 13 If I notice an unexplained bodily sensation, I often find it difficult to think about other things. 2 53
15 John W 14 My family/friends would say I worry too much about my health. 2 53
16 John W 15 If I had a serious illness, I would still be able to enjoy things in my life a little. 1 53
17 John W 16 If I developed a serious illness there is a moderate chance that modern medicine would be able to cure me. 1 53
18 John W 17 A serious illness would ruin many aspects of my life. 1 53
19 John W 18 If I had a serious illness I would feel that I had lost quite a lot of my dignity. 2 53
  • navigate_next Export patient responses including the calculated HAI-18 score and anxiety severity to Google Sheets for easy record-keeping
  • navigate_next Export individual points for 18 criteria to Google Sheets for data manipulation and analysis for comprehensive insights
  • navigate_next Use pre-built reports to easily keep track of patient progress over time and monitor changes in their health anxiety symptoms
  • navigate_next Receive a copy of the response and the calculated HAI-18 score by email whenever a patient submits their HAI-18 assessment
  • navigate_next Use data in Google Sheets to integrate with external EHR systems for seamless data transfer

HIPAA compliance

Patient ID: 1004
Patient Name: ******
Patient Email: ******
Patient Phone Number: ******
Doctor's Name: Dr. Smith
Location: New York
1: I spend much of my time worrying about my health
2: I notice aches/pains more than most other people of my age
3: I am often aware of bodily sensations or changes.
4: I try to resist thoughts of illness but am often unable to do so.
5: I am often afraid that I have a serious illness
6: I frequently have images of myself being ill.
7: I often have difficulty in taking my mind off thoughts about my health.
8: I am initially relieved but the worries always return later.
9: If I hear about an illness I often think I have it myself.
10: If I have a bodily sensation or change I always wonder what it means.
11: I usually feel at moderate risk of developing a serious illness.
12: I often think I have a serious illness.
13: If I notice an unexplained bodily sensation, I often find it difficult to think about other things.
14: My family/friends would say I worry too much about my health.
15: If I had a serious illness, I would still be able to enjoy things in my life a little.
16: If I developed a serious illness there is a moderate chance that modern medicine would be able to cure me.
17: A serious illness would ruin many aspects of my life.
18: If I had a serious illness I would feel that I had lost quite a lot of my dignity.
Health Anxiety: 45
Negative Consequences: 8
Total score: 53
Total score: 53
  • navigate_next Create a HIPAA compliant HAI-18 assessment form to safely collect, store and access patient responses
  • navigate_next Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
  • navigate_next Automatically mask PHI fields when exporting HAI-18 form responses to Google Sheets and sending them on email
  • navigate_next Prepopulate patient details in HAI-18 assessments by creating secure prefill links without exposing PHI
  • navigate_next Limit access to patient data only for authorized personnel and minimize the risk of data breaches

These reviews are reproduced without modification from Google Workspace Marketplace.

July 27, 2023

5 stars

I am 100% a fan of this company. We use HIPAA compliant Google Forms and needed a way to collect signatures, the industry standard company is TOO expensive. I started using FormEsign and it worked perfectly. It lacked the ability to provide a pdf copy of the form after signature. This company worked with me help their product evolve into something that could benefit all future clients AND the end user. The team was polite, professional, kind, enthusiastic, and willing to make a change. This earned my loyalty. I will sing their praises. Good work, and thank you!

— Royal Bush

July 23, 2023

5 stars

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— Sol Evans

February 16, 2024

1 stars

Does not work

— Myles Sicuro

October 31, 2023

5 stars

We needed a way to create forms with e-signatures and this app made it very easy. Support is also very quick and always helpful. Cannot recommend enough!

— Chris Henesy

July 12, 2023

5 stars

It very friendly to used. I love it. For my case multiple signature needed. it's supporting

— Senthil Kumar

November 27, 2023

5 stars

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July 10, 2023

5 stars

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