--- title: Neonatal Abstinence Syndrome Nurse Wellness Check Form Template | Paperform description: Compassionate wellness check form for nurses caring for substance-exposed infants. Address compassion fatigue, emotional wellbeing, and the unique challenges of NAS care. url: "https://paperform.co/templates/neonatal-abstinence-syndrome-nurse-wellness-check-form" type: static generatedAt: "2026-04-04T00:44:41.753Z" --- [← Back to free form templates](/templates/) ![Neonatal Abstinence Syndrome Nurse Wellness Check Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/neonatal-abstinence-syndrome-nurse-wellness-check-form.png) [Preview](https://_preview.paperform.co/ai-template/neonatal-abstinence-syndrome-nurse-wellness-check-form) [Use this template for free](/create?ai-template=neonatal-abstinence-syndrome-nurse-wellness-check-form) [Emergency & Crisis Forms](/templates/category/emergency-crisis/)[Healthcare & Medical Forms](/templates/category/healthcare/) [Healthcare](/templates/industry/healthcare/)[Mental Health](/templates/industry/mental-health/) [Manager](/templates/role/manager/)[Nurse](/templates/role/nurse/)[Healthcare Administrator](/templates/role/healthcare-admin/) About this free form template Caring for infants with neonatal abstinence syndrome (NAS) is one of the most emotionally demanding roles in healthcare. Nurses in this specialty face unique stressors: managing infant withdrawal symptoms, supporting mothers navigating addiction recovery, avoiding judgment while providing compassionate care, and processing the grief that comes with foster placements. This **Neonatal Abstinence Syndrome Nurse Wellness Check Form** provides a safe, confidential space for NAS nurses to reflect on their emotional wellbeing, identify signs of compassion fatigue, and access support resources. The form addresses the specific challenges of substance-exposed infant care, including the emotional toll of witnessing infant suffering, maintaining non-judgmental care for mothers facing stigma, and coping with the loss felt when infants transition to foster care. Healthcare administrators can use this template to establish regular wellness check-ins for NAS unit staff, identify burnout risks early, and connect nurses with appropriate support services. The form balances clinical assessment with empathetic questions that acknowledge the profound emotional labor involved in this work. For hospitals and healthcare facilities looking to automate follow-up care and support workflows, **Stepper** (stepper.io) can route wellness check responses to appropriate departments—triggering counseling referrals, peer support group invitations, or manager follow-ups based on responses. This ensures no nurse falls through the cracks when they need support most. Paperform's conditional logic allows the form to adapt based on responses, showing additional resources or questions only when indicators of distress are present, creating a personalized and supportive experience for each nurse. Built for growing businesses, trusted by bigger ones. Trusted by 500K+ business owners and creators, and hundreds of millions of respondents. ![Capterra - 4.8 out of 5](/images/capterra-st.jpg) ![Trustpilot - 4.8 out of 5](/images/trustpilot-st.jpg) ![G2 - 4.8 out of 5](/images/g2-st.jpg) [Try Paperform free now](/register) ## More templates like this [![Medical Director Wellness Check - Residential Substance Abuse Treatment](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/medical-director-wellness-check-residential-substance-abuse-treatment.png) ### Medical Director Wellness Check - Residential Substance Abuse Treatment A comprehensive wellness check form for medical directors overseeing residential substance abuse treatment programs, covering detoxification protocols, medication-assisted treatment, co-occurring disorders, and recovery philosophy alignment.](/templates/medical-director-wellness-check-residential-substance-abuse-treatment/) [![Psychiatric Intensive Care Unit Nurse 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