Teen Health Risk Questionnaire
These questionnaires can be used to ask teens about their health behaviors or risks. They can be useful to better understand a youth’s current health strengths and risks, and can be used as clinical tools for health history, risk assessment, and an aide to the psychosocial interview.
Please note that the questionnaires listed below are not validated screening instruments and cannot be billed as such. They are not a substitute for standardized mental health or depression screening. For more information about mental health or depression screening in young people 6-21 years of age, refer to the Child and Teen Checkups (C&TC) website and to the MDH C&TC Mental Health Screening (6-21 years) Fact Sheet.
- Teen Screen (long form) (PDF). This form has 22 questions and can be completed in about 5 minutes.
- Exploración de la Salud de Adolescentes (PDF) 22 preguntas
- Teen Screen (short form) (PDF). This form has 10 questions and just covers the basics.
- Exploración de la Salud de Adolescentes (PDF) 10 preguntas
- HEADSSS format. The HEADSSS format is a series of questions that cover the important areas of a teen's life. The questions or the general format can be integrated into any teen visit or health conversation. See HEADSSS Quick Screen or HEADSSS Long Form.
Minnesota Health Improvement Partnership Adolescent Health Services Action Team in partnership with the Minnesota Department of Health, 2006