• Call: (844) 569-8628
  • |
  • Get a Quote
  • |
  • COVID-19 Updates
  • |
  • Log In
DrChrono gray logo
  • Solutions
    • Providers
    • EHR by Specialty
    • Telemedicine
    • Large Practice
    • Small Practice
    • Multi Specialty

    • Patients
    • Patient Portal - OnPatient

    • Partners & Affiliates
    • Become a Partner
    • API Developers
    • Affiliate Information
    • Apple Mobility Program
  • Platform
    • Product
    • Electronic Health Records
    • Telehealth
    • Practice Management
    • Medical Billing
    • Revenue Cycle Management
    • Patient Portal
    • Mobile EHR Solutions
    • App Marketplace

    • Features
    • All Features
    • Lab & Imaging
    • eRx & EPCS
    • Medical Templates
    • Feature videos
  • Resources
    • Resources & Tools
    • Resources
    • Case Studies
    • Blog
    • Specialties
    • Testimonials
    • Webinars
    • Plans
    • ONC Certification

    • Customer Help
    • Support Center
    • Training videos
  • Company
    • About Us
    • Blog
    • Diversity
    • Life & Culture
    • Press
  • Telehealth
  • Try Now
DrChrono gray logo mobile menu icon
Close out of menu icon
  • Solutions
    • Providers
    • EHR by Specialty
    • Telemedicine
    • Large Practice
    • Small Practice
    • Multi Specialty

    • Patients
    • Patient Portal - OnPatient

    • Partners & Affiliates
    • Become a Partner
    • API Developers
    • Affiliate Information
    • Apple Mobility Program
  • Platform
    • Product
    • Electronic Health Records
    • Telehealth
    • Practice Management
    • Medical Billing
    • Revenue Cycle Management
    • Patient Portal
    • Mobile EHR Solutions
    • App Marketplace

    • Features
    • All Features
    • Lab & Imaging
    • eRx & EPCS
    • Medical Templates
    • Feature videos
  • Resources
    • Resources & Tools
    • Resources
    • Case Studies
    • Blog
    • Specialties
    • Testimonials
    • Webinars
    • Plans
    • ONC Certification

    • Customer Help
    • Support Center
    • Training videos
  • Company
    • About Us
    • Blog
    • Diversity
    • Life & Culture
    • Press
  • Try Now Log In
Repeated, disturbing, and unwanted memories of the stressful experience?
• • •
Repeated, disturbing dreams of the stressful experience?
• • •
Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reli
• • •
Feeling very upset when something reminded you of the stressful experience?
• • •
Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, sweating)
• • •
Avoiding memories, thoughts, or feelings related to the stressful experience?
• • •
Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, or objects)
• • •
Trouble remembering important parts of the stressful experience?
• • •
Having strong negative beliefs about yourself, other people, or the world
• • •
Blaming yourself or someone else for the stressful experience or what happened after it?
• • •
Having strong negative feelings such as fear, horror, anger, guilt, or shame?
• • •
Loss of interest in activities that you used to enjoy?
• • •
Feeling distant or cut off from other people?
• • •
Trouble experiencing positive feelings
• • •
Irritable behavior, angry outbursts, or acting aggressively?
• • •
Taking too many risks or doing things that could cause you harm?
• • •
Being “superalert” or watchful or on guard?
• • •
Feeling jumpy or easily startled?
• • •
Having difficulty concentrating?
• • •
Trouble falling or staying asleep?
• • •

Post Traumatic Stress Disorder (PCL-5) Medical Form

Acupuncture

There are 2 copies in use.
Published: March 2, 2022, 4:01 p.m.
Doctor: Dr. History Physical
Rating: 0   /

Use this form Back to list

Download Post Traumatic Stress Disorder (PCL-5)

If you have an account, log in to use or rate this form. Log In

Click to use an int'l or other #

Don't have an account? Sign up to use this form. Sign Up

Close
DrChrono white logo

328 Gibraltar Dr
Sunnyvale, CA 94089

Call us: (844) 569-8628

Apple app store logo
  • Free EHR Demo
  • EHR
  • Practice Management
  • Medical Billing
  • Revenue Cycle
    Management
  • Patient Portal
  • Mobile EHR
  • eRx
  • Plans
  • EHR Features
  • Lab & Imaging
  • Patient Education Materials
  • Universities & Schools
  • Security Policy
  • SSO Log In
  • EHR Checklist
  • Meaningful Use
  • EPCS
  • MACRA & MIPS
  • ICD-10 Info
  • Share your Experience
  • OnPatient Portal
  • OnPatient Terms of Use
  • OnPatient Privacy Policy
  • Security Policy
  • Support Center
  • Developer API & SDK
  • EHR FAQ
  • Medical Billing Calculator
  • Medical Form Library
  • Insurance Lookup
  • ICD & HCPCS Lookup
  • App Directory
  • About Us
  • News & Updates
  • Careers
  • Contact Us
  • Testimonials
  • Logos & Branding
  • Our Flickr
  • Press
© Copyright 2019 DrChrono Inc.
  • Privacy Policy
  • Terms of Use
  • Site Map
  • twitter icon
  • facebook icon
  • youtube icon