Clinician-administered rating scale

Hamilton Anxiety Rating Scale (HAM-A)

Fourteen Questions • Five Responses

Rate the patient by selecting the answer that best describes the extent to which each condition is present. Choose one of the five responses for every question.

Patricia Masuda-Story, Psy.D., QME drstory@atomicshrink.com

Rating progress0 of 14 rated

Patient Information

Enter the patient information before completing the rating scale.

Patient Name

Date of Birth

Today’s Date

How to Complete This Form

READ THESE STEPS CAREFULLY:

1. Fill in the patient’s name, date of birth, and today’s date above.

2. For each of the 14 questions below, click the box that best describes how severe the symptom is for the patient (0 = Not present … 4 = Very severe).

3. You must rate all 14 questions. The progress bar at the top shows how many are done.

4. Check the confirmation box, then click the blue button OPEN EMAIL DRAFT WITH COMPLETED RATING.

5. Your email program will open with the completed rating already addressed to Dr. Story. You must still press Send inside your email program or the rating will not be delivered.

0Not present

1Mild

2Moderate

3Severe

4Very severe

I confirm that all fourteen questions have been completed.

Total Score 0 / 56

Send the completed rating by email

After every item is rated, click the blue button below. An email draft addressed to Dr. Story will open with the patient information, total score, and all ratings already filled in. Then press Send in your email app.

IMPORTANT: Clicking the blue button does NOT send the rating.

It only opens an email draft that is already addressed to Dr. Story (drstory@atomicshrink.com) and already contains the completed ratings. You must open your email app and press Send. If you close the draft or forget to press Send, we will not receive the rating.