--- title: Panic Disorder Assessment Form Template - Pre-Visit Symptom Screening | Paperform description: Professional panic disorder assessment form for mental health providers. Screen for panic attacks, physical symptoms, and agoraphobia with this comprehensive pre-visit template. url: "https://paperform.co/templates/panic-disorder-assessment-form" type: static generatedAt: "2026-04-04T00:44:47.564Z" --- [← Back to free form templates](/templates/) ![Panic Disorder Assessment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/panic-disorder-assessment-form.png) [Preview](https://_preview.paperform.co/ai-template/panic-disorder-assessment-form) [Use this template for free](/create?ai-template=panic-disorder-assessment-form) [Intake Forms](/templates/category/intake-forms/)[Verification & Validation Forms](/templates/category/verification/)[Healthcare & Medical Forms](/templates/category/healthcare/) [Healthcare](/templates/industry/healthcare/)[Mental Health](/templates/industry/mental-health/) [Physician](/templates/role/physician/)[Therapist](/templates/role/therapist/)[Counselor](/templates/role/counselor/)[Psychologist](/templates/role/psychologist/)[Social Worker](/templates/role/social-worker/)[Healthcare Administrator](/templates/role/healthcare-admin/) About this free form template ### Streamline Mental Health Intake with a Professional Panic Disorder Assessment Form Panic disorder affects millions of people worldwide, and early screening is essential for effective treatment. This **Panic Disorder Assessment Form** template helps mental health professionals, therapists, psychiatrists, and healthcare providers conduct thorough pre-visit symptom evaluations with clarity and compassion. Built with Paperform, this template combines the clinical rigor needed for accurate screening with a patient-friendly interface that reduces anxiety during the assessment process. The form guides patients through panic attack frequency tracking, a comprehensive physical symptom checklist, and agoraphobia screening questions—all in a structured, easy-to-follow format. #### Perfect for Mental Health Professionals and Healthcare Providers Whether you're a licensed therapist conducting initial intake assessments, a psychiatrist screening for anxiety disorders, or a primary care physician evaluating patients before specialist referral, this form streamlines your pre-visit workflow. The conditional logic built into the template ensures patients only see relevant follow-up questions, creating a personalized assessment experience while capturing all the clinical data you need. #### Seamlessly Integrate with Your Practice Management Tools Paperform's powerful integrations mean every assessment automatically flows into your existing systems. Send responses directly to your EHR, trigger follow-up appointment emails through your calendar system, or route urgent cases to your clinical team via Slack. With **Stepper** (stepper.io), you can create automated workflows that flag high-risk assessments, schedule immediate follow-ups, or assign cases to specific providers based on symptom severity. For practices managing multiple providers or locations, Paperform's Agency+ features let you maintain consistent assessment standards while customizing branding and routing for each clinical team. Plus, with SOC 2 Type II compliance and robust security features, patient data stays protected every step of the way. #### From Assessment to Treatment Plan This panic disorder screening template is designed to work as part of a complete patient journey. Use Paperform to create a connected suite of mental health forms—from initial symptom assessment through treatment consent forms that can be signed electronically with **Papersign** (papersign.com). Keep all patient documentation linked, secure, and accessible when you need it. Start delivering more efficient, patient-centered mental health care today with Paperform's Panic Disorder Assessment Form template. 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 [![Mental Health Intake & Symptom Assessment](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/mental-health-intake-symptom-assessment.png) ### Mental Health Intake & Symptom Assessment A comprehensive mental health intake form with PHQ-9 depression screening, GAD-7 anxiety assessment, and automated crisis intervention routing for safer, more informed care.](/templates/mental-health-intake-symptom-assessment/) [![OCD Symptom Severity Scale](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/ocd-symptom-severity-scale.png) ### OCD Symptom Severity Scale A comprehensive OCD symptom assessment form measuring obsession themes, compulsion frequency, and functional impairment to help healthcare providers understand symptom severity before appointments.](/templates/ocd-symptom-severity-scale/) [![Mental Health Intake & Symptom Assessment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/mental-health-intake-symptom-assessment-form.png) ### Mental Health Intake & Symptom Assessment Form A comprehensive mental health intake form with PHQ-9 depression screening, GAD-7 anxiety assessment, and crisis intervention routing to ensure appropriate care pathways.](/templates/mental-health-intake-symptom-assessment-form/) [![Chronic Nausea & Hyperemesis Mental Health Intake Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/chronic-nausea-hyperemesis-mental-health-intake-form.png) ### Chronic Nausea & Hyperemesis Mental Health Intake Form A specialized mental health intake form for patients experiencing chronic nausea and hyperemesis, assessing symptom severity, nutritional status, medical history, and quality of life impact.](/templates/chronic-nausea-hyperemesis-mental-health-intake-form/) [![Eating Disorder Screening Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/eating-disorder-screening-form.png) ### Eating Disorder Screening Form A comprehensive eating disorder screening tool featuring the Eating Attitudes Test (EAT-26), body image assessment, and nutritional risk evaluation to identify individuals who may benefit from professional evaluation and support.](/templates/eating-disorder-screening-form/) [![Ketamine-Assisted Psychotherapy Screening Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/ketamine-assisted-psychotherapy-screening-form.png) ### Ketamine-Assisted Psychotherapy Screening Form A comprehensive screening form for ketamine-assisted psychotherapy programs, evaluating treatment-resistant depression history, medical clearance requirements, and integration session planning for prospective patients.](/templates/ketamine-assisted-psychotherapy-screening-form/) [![Ketamine Therapy for Depression - Patient Intake Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/ketamine-therapy-for-depression-patient-intake-form.png) ### Ketamine Therapy for Depression - Patient Intake Form Comprehensive intake form for patients seeking ketamine therapy for treatment-resistant depression, including psychiatric history, medication trials, and safety screening.](/templates/ketamine-therapy-for-depression-patient-intake-form/) [![Medical Detox Admission Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/medical-detox-admission-form.png) ### Medical Detox Admission Form A comprehensive medical detox intake form for assessing substance dependence severity, withdrawal risks, co-occurring mental health conditions, and medication-assisted treatment eligibility.](/templates/medical-detox-admission-form/) [![Memory Clinic Cognitive Assessment Intake Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/memory-clinic-cognitive-assessment-intake-form.png) ### Memory Clinic Cognitive Assessment Intake Form A comprehensive intake form for memory clinics to assess cognitive decline, screen for dementia, evaluate caregiver burden, and identify safety concerns for new patients.](/templates/memory-clinic-cognitive-assessment-intake-form/) [![Psychosis Early Intervention Assessment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/psychosis-early-intervention-assessment-form.png) ### Psychosis Early Intervention Assessment Form A comprehensive first-episode psychosis screening and coordinated specialty care enrollment form for mental health services, including clinical assessment, family education needs, and treatment planning.](/templates/psychosis-early-intervention-assessment-form/) [![PTSD Symptom Checklist & Assessment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/ptsd-symptom-checklist-assessment-form.png) ### PTSD Symptom Checklist & Assessment Form A comprehensive pre-visit assessment form for evaluating PTSD symptoms, trauma exposure history, flashback frequency, and avoidance behaviors to help healthcare providers prepare for patient consultations.](/templates/ptsd-symptom-checklist-assessment-form/) [![Telehealth Eating Disorder Assessment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/telehealth-eating-disorder-assessment-form.png) ### Telehealth Eating Disorder Assessment Form A comprehensive virtual assessment form for eating disorder treatment that tracks meal plan adherence, evaluates body image concerns, monitors exercise patterns, and obtains family-based treatment consent.](/templates/telehealth-eating-disorder-assessment-form/)