Free Herdman Assessment Form*
a comprehensive bio-psycho-social semi-structured interview
Fill Out
the Form


Herdman Assessment Form Features 


Developed by the industry expert John W. Herdman, Ph.D., LADC, ICADC  

The Herdman Assessment Form is a comprehensive bio-psycho-social questionnaire that leads to a reader-friendly narrative report. The conclusions, diagnosis and level of care recommendations remain the professional responsibility of the counselor completing the assessment. The Electronic Assessment enables practitioners to keep all client data neat and organized, while avoiding data entry mistakes or repetitive errors.
Standard Sections Include: Optional Sections Include:
 Presenting Problem/Primary Complaint
 Demographic Information
 Alcohol and Drug History
 Psychiatric History
 Medical and Legal History
 Education, Employment and Military History
 Family History and Family Relationships
 SASSI-3 Reporting
 University of Rhode Island Change Assessment (URICA)
 ASAM Patient Placement Criteria Rating
 Diagnostic Impression using the DSM-IV TR Axes
 Section for Written Summary of the Assessment


* We are glad to offer this complimentary Herdman Assessment Form and help you make the process of creating assessment reports quick and simple. Please remember, in the Free edition, the data is not saved after it is filled out and printed. To be able to save data, organize it with client profiles and do much more the HAF has to be used with the complete MyCaseRecords system.

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Please enjoy this Free electronic assessment tool designed specifically for alcohol and drug abuse professionals and brought to you by MyCaseRecords.

We encourage you to test-drive a full version of our case management software with a FREE 30-day Trial available exclusively at MyCaseRecords.com
MyCaseRecords is a web based practice management software for substance abuse counselors and other behavioral health professionals. MyCaseRecords case management system assists in increasing operational efficiency of drug rehabilitation centers and other substance abuse facilities. Features include automation of treatment plans & notes, workflow & document management.