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Postpartum Depression Screening (EPDS) Form

Postpartum Depression Screening (EPDS) Form

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Postpartum Depression Screening (EPDS) Form

Edinburgh Postnatal Depression Scale-based screener administered at well-baby visits to identify postpartum mood concerns.

Please reflect on how you have felt over the past 7 days - not just today. Your honest answers help us support you.

Patient name *

Your answer

Date of birth

Baby's date of birth

I have been able to laugh and see the funny side of things

As much as I always could

Not quite so much now

Definitely not so much now

Not at all

I have looked forward with enjoyment to things

As much as I ever did

Rather less than I used to

Definitely less than I used to

Hardly at all

I have blamed myself unnecessarily when things went wrong

Yes, most of the time

Yes, some of the time

Not very often

No, never

I have been anxious or worried for no good reason

No, not at all

Hardly ever

Yes, sometimes

Yes, very often

+ 9 more questions

About this template

Edinburgh Postnatal Depression Scale-based screener administered at well-baby visits to identify postpartum mood concerns.

How does it work?

1

Click Use template. We'll drop a copy into your Formswrite workspace - no setup needed.

2

Tweak the questions, branding, and logic to fit your workflow. Add your logo, colors, and cover image.

3

Publish and share the link, embed it on your site, or drop it into a chatbot widget. Responses stream straight to your dashboard.

Categories

Health

17 questions · Free


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