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NCPTSD Assessment Instrument Request Form

PLEASE NOTE: Access to these professional instruments is somewhat limited. The American Psychological Association's ethical guidelines on psychological test instruments require advanced graduate level training in the administration and interpretation of psychodiagnostic assessment instruments. Thus, typically we are not able to distribute the measure to people who do not hold at least a master's degree in a clinical discipline. Access to these measures requires proof of clinical status or research credentials. Please also clarify your intended use of the measure. Students who want measures for course papers are encouraged to use sample items or have their clinical professors make the formal request.

To request any of the listed NCPTSD assessment instruments, complete and submit this form online, OR print the completed form and mail to the address listed at the bottom of the page.

The following scales are now available online in PDF format:
TESI-C (Traumatic Events Screening Inv. - Child)
Combat Exposure Scale
Primary Care PTSD Screen (PC-PTSD)


Fields marked with * are required. Allow 7-10 days for processing.

I would like a copy of: CAPS (Clinician-Administered PTSD Scale)
CAPS-CA (Child & Adolescent version of CAPS)
Mississippi Scale for Combat-Related PTSD
PTSD Checklist - Civilian
PTSD Checklist - Military
PTSD Checklist - Specific
Trauma History Screen
Deployment Risk & Resiliency Inventory (DRRI: 14 scales)
DRRI MANUAL
Your Name:*
Address:*
Street
City State Zip
Country
E-Mail Address:*
Telephone:*
Fax:
Profession:*
Degree:*
Affiliation:*
Proposed use of instrument:*

ONLY the scales listed above can be requested with this form. For other assessment instruments see information on the individual measure you are interested in.

I prefer to be contacted by:

By submitting this form I certify that I have advanced graduate level training in the administration and interpretation of psychodiagnostic assessment instruments; hold at least a master's degree in a clinical discipline; or possess research credentials.

or

If you prefer to make your request by mail-

Print this form and mail to:
Assessment Requests
National Center for PTSD (116D)
VA Medical Center
215 N. Main St.
White River Junction, VT 05009

Do NOT try to diagnose yourself for PTSD. Please contact your doctor or a mental health specialist. You can get more information about how to get help in the following Fact Sheets:

Specialized PTSD Treatment Programs in the U.S. Department of Veterans Affairs
Finding a Therapist

You may also want to visit the Where to Get Help page for additional resources.

PLEASE NOTE: The NCPTSD will not provide assessment tools to untrained professionals.


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