Insomnia Severity Index
21 reviews
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Use our readymade template to create your Insomnia Severity Index (ISI) screening tool for insomnia

Create your care assessments

ISI score Insomnia Level Proposed treatment
0-7 No clinically significant insomnia May not need treatment
8-14 Subthreshold insomnia Watchful waiting
15-21 Clinical insomnia (moderate severity) Consider counseling
22-28 Clinical insomnia (severe) Active treatment
  • navigate_next Prebuilt template with ISI scoring to assess the presence of insomnia and measure its severity
  • navigate_next 7-item questionnaire that scores each of the 7 criteria as “0” (None) to “4” (Very Severe)
  • navigate_next Real-time calculation of ISI Score and insomnia level based on the form responses
  • navigate_next Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
  • navigate_next Compare the scores from the initial screening with that of the followup to track the progression of insomnia
  • navigate_next Easily create responsive forms that allow patients to complete their assessments on any device at any time

Collect responses from your patients

Patient ID 1004
Patient Name John W
Patient Email johnw@ymail.com
Patient Phone Number 0987654321
Please rate the CURRENT (i.e. LAST 2 WEEKS) SEVERITY of your insomnia problem(s).
Difficulty falling asleep Moderate
Difficulty staying asleep Severe
Problems waking up too early Very Severe
How SATISFIED/DISSATISFIED are you with your CURRENT sleep pattern? Dissatisfied
How NOTICEABLE to others do you think your sleep problem is in terms of impairing the quality of your life? Much
How WORRIED/DISTRESSED are you about your current sleep problem Very Much Noticeable
To what extent do you consider your sleep problem to INTERFERE with your daily functioning (e.g. daytime fatigue, mood, ability to function at work/daily chores, concentration, memory, mood, etc.) CURRENTLY? Very Much Interfering
ISI Score 23
Insomnia Level Clinical insomnia (severe)
  • navigate_next Pre-populate patient details such as patient id, name, email etc in the ISI assessment form before sharing it with the patients
  • navigate_next Send an email invitation with a secure link for patients to complete their ISI assessment form prior to their visit
  • navigate_next Allow patients to save their progress and complete their ISI assessment form at a later time without losing any responses
  • navigate_next Set up an email template for your ISI assessment and automatically send invitation emails to multiple patients with ease
  • navigate_next Send a confirmation email to the patients with their ISI score, diagnosis, next steps when they submit their ISI assessment

Track patient responses in Google Sheets

A B C D E
1 Name Question Answer Score Total Score
2 John W Difficulty falling asleep Moderate 2 23
3 John W Difficulty staying asleep Severe 3 23
4 John W Problems waking up too early Very Severe 4 23
5 John W How SATISFIED/DISSATISFIED are you with your CURRENT sleep pattern? Dissatisfied 3 23
6 John W How NOTICEABLE to others do you think your sleep problem is in terms of impairing the quality of your life? Much 3 23
7 John W How WORRIED/DISTRESSED are you about your current sleep problem Very Much Noticeable 4 23
8 John W To what extent do you consider your sleep problem to INTERFERE with your daily functioning (e.g. daytime fatigue, mood, ability to function at work/daily chores, concentration, memory, mood, etc.) CURRENTLY? Very Much Interfering 4 23
  • navigate_next Export patient responses including the calculated ISI score and insomnia level to Google Sheets for easy record-keeping
  • navigate_next Export individual points for 7 criteria to Google Sheets for data manipulation and analysis for comprehensive insights
  • navigate_next Use pre-built reports to easily keep track of patient progress over time and monitor changes in their insomnia symptoms
  • navigate_next Receive a copy of the response and the calculated ISI score by email whenever a patient submits their ISI assessment
  • navigate_next Use data in Google Sheets to integrate with external EHR systems for seamless data transfer

HIPAA compliance

Patient ID: 1004
Patient Name: ******
Patient Email: ******
Patient Phone Number: ******
Please rate the CURRENT (i.e. LAST 2 WEEKS) SEVERITY of your insomnia problem(s).
Difficulty falling asleep:Moderate
Difficulty staying asleep:Severe
Problems waking up too early:Very Severe
How SATISFIED/DISSATISFIED are you with your CURRENT sleep pattern?: Dissatisfied
How NOTICEABLE to others do you think your sleep problem is in terms of impairing the quality of your life?: Much
How WORRIED/DISTRESSED are you about your current sleep problem : Very Much Noticeable
To what extent do you consider your sleep problem to INTERFERE with your daily functioning (e.g. daytime fatigue, mood, ability to function at work/daily chores, concentration, memory, mood, etc.) CURRENTLY?: Very Much Interfering
ISI Score: 23
Insomnia Level: Clinical insomnia (severe)
ISI Score: 23
Insomnia Level: Clinical insomnia (severe)
  • navigate_next Create a HIPAA compliant ISI assessment form to safely collect, store and access patient responses
  • navigate_next Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
  • navigate_next Automatically mask PHI fields when exporting ISI form responses to Google Sheets and sending them on email
  • navigate_next Prepopulate patient details in ISI assessments by creating secure prefill links without exposing PHI
  • navigate_next Limit access to patient data only for authorized personnel and minimize the risk of data breaches

These reviews are reproduced without modification from Google Workspace Marketplace.

July 27, 2023

5 stars

I am 100% a fan of this company. We use HIPAA compliant Google Forms and needed a way to collect signatures, the industry standard company is TOO expensive. I started using FormEsign and it worked perfectly. It lacked the ability to provide a pdf copy of the form after signature. This company worked with me help their product evolve into something that could benefit all future clients AND the end user. The team was polite, professional, kind, enthusiastic, and willing to make a change. This earned my loyalty. I will sing their praises. Good work, and thank you!

— Royal Bush

July 23, 2023

5 stars

I am not tech savvy. I chose formesign to help create registration links for clients. Vipid has been great in assisting me. He goes above and beyond. My company now has moved from the stone age to modern age through the ability to use this feature. Of the many features I am impressed with, the ability to update a form without needing to regenerate a link is amazing. I often make mistakes and that ability allows me to fix mistakes without needing to change everything. Thank you!!!

— Sol Evans

February 16, 2024

1 stars

Does not work

— Myles Sicuro

October 30, 2023

5 stars

We needed a way to create forms with e-signatures and this app made it very easy. Support is also very quick and always helpful. Cannot recommend enough!

— Chris Henesy

July 12, 2023

5 stars

It very friendly to used. I love it. For my case multiple signature needed. it's supporting

— Senthil Kumar

November 27, 2023

5 stars

Yeah this is good for all

— luqman khan

July 10, 2023

5 stars

We were looking for a way to have a signature option in our form. Formesign addon allowed us to collect signatures for the acknowledgment and consent forms. It was simple and easy to setup. Very useful addon for google forms.

— Joan S

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