To be administered by a health care professional

Hamilton Depression Rating Scale (HAM-D)

21 Areas • Total Items 1 to 17

Rate the severity of depression. The total score is calculated from the first 17 items only.

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

Rating progress0 of 21 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 EVERY STEP 1. Fill in the patient’s name, date of birth, and today’s date above.

2. Rate all 21 areas below. The total score uses only Items 1–17.

3. You must complete every item. The progress bar shows how many are finished.

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.

I confirm that all 21 areas have been completed.

TOTAL ITEMS 1 TO 17 0 / 50

Item 3 is rated above 0. Immediate clinical review is required before concluding or transmitting this assessment.

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, severity, 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.