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Use our readymade template to create your Bergen Shopping Addiction Scale (BSAS) screening tool for shopping addiction
Create your care assessments
| BSAS score | Shopping Addiction |
|---|---|
| 0-3 | No |
| 4-28 | Yes |
- Prebuilt template with BSAS scoring to assess the presence of shopping addiction and measure its severity
- 28-item questionnaire that scores each item from “0” (completely disagree) to “4” (completely agree)
- Real-time calculation of BSAS Score and shopping addiction based on the form responses
- Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
- Compare the scores from the initial screening with that of the followup to track the progression of shopping addiction
- 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 |
| 1. Shopping/buying is the most important thing in my life. | Agree |
| 2. I think about shopping/buying things all the time. | Agree |
| 3. I spend a lot of time thinking of or planning shopping/buying. | Agree |
| 4. Thoughts about shopping/buying keep popping in my head. | Agree |
| 5. I shop in order to feel better. | Agree |
| 6. I shop/buy things in order to change my mood. | Agree |
| 7. I shop/buy things in order to forget about personal problems. | Agree |
| 8. I shop/buy things in order to reduce feelings of guilt, anxiety, helplessness, loneliness, and/or depression. | Agree |
| 9. I shop/buy so much that it negatively affects my daily obligations (e.g., school and work). | Agree |
| 10. I give less priority to hobbies, leisure activities, job/studies, or exercise because of shopping/buying. | Agree |
| 11. I have ignored love partner, family, and friends because of shopping/buying. | Agree |
| 12. I often end up in arguments with other because of shopping/buying. | Agree |
| 13. I feel an increasing inclination to shop/buy things. | Agree |
| 14. I shop/buy much more than I had intended/planned. | Agree |
| 15. I feel I have to shop/buy more and more to obtain the same satisfaction as before. | Agree |
| 16. I spend more and more time shopping/buying. | Agree |
| 17. I have tried to cut down on shopping/buying without success. | Agree |
| 18. I have been told by others to reduce shopping/buying without listening to them. | Agree |
| 27. I have worried so much about my shopping that it sometimes has made me sleepless. | Agree |
| 28. I have been bothered with poor conscience because of shopping/buying. | Agree |
| Total Score | 88 |
| BSAS Score | 7 |
| Shopping Addiction | Yes |
- Pre-populate patient details such as patient id, name, email etc in the BSAS assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their BSAS assessment form prior to their visit
- Allow patients to save their progress and complete their BSAS assessment form at a later time without losing any responses
- Set up an email template for your BSAS assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their BSAS score, diagnosis, next steps when they submit their BSAS assessment
Track patient responses in Google Sheets
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | Name | Question | Answer | Score | Total Score |
| 2 | John W | 1. Shopping/buying is the most important thing in my life. | Agree | 3 | 7 |
| 3 | John W | 2. I think about shopping/buying things all the time. | Agree | 3 | 7 |
| 4 | John W | 3. I spend a lot of time thinking of or planning shopping/buying. | Agree | 3 | 7 |
| 5 | John W | 4. Thoughts about shopping/buying keep popping in my head. | Agree | 3 | 7 |
| 6 | John W | 5. I shop in order to feel better. | Agree | 3 | 7 |
| 7 | John W | 6. I shop/buy things in order to change my mood. | Agree | 3 | 7 |
| 8 | John W | 7. I shop/buy things in order to forget about personal problems. | Agree | 3 | 7 |
| 9 | John W | 8. I shop/buy things in order to reduce feelings of guilt, anxiety, helplessness, loneliness, and/or depression. | Agree | 3 | 7 |
| 10 | John W | 9. I shop/buy so much that it negatively affects my daily obligations (e.g., school and work). | Agree | 3 | 7 |
| 11 | John W | 10. I give less priority to hobbies, leisure activities, job/studies, or exercise because of shopping/buying. | Agree | 3 | 7 |
| 12 | John W | 11. I have ignored love partner, family, and friends because of shopping/buying. | Agree | 3 | 7 |
| 13 | John W | 12. I often end up in arguments with other because of shopping/buying. | Agree | 3 | 7 |
| 14 | John W | 13. I feel an increasing inclination to shop/buy things. | Agree | 3 | 7 |
| 15 | John W | 14. I shop/buy much more than I had intended/planned. | Agree | 3 | 7 |
| 16 | John W | 15. I feel I have to shop/buy more and more to obtain the same satisfaction as before. | Agree | 3 | 7 |
| 17 | John W | 16. I spend more and more time shopping/buying. | Agree | 3 | 7 |
| 18 | John W | 17. I have tried to cut down on shopping/buying without success. | Agree | 3 | 7 |
| 19 | John W | 18. I have been told by others to reduce shopping/buying without listening to them. | Agree | 3 | 7 |
| 20 | John W | 27. I have worried so much about my shopping that it sometimes has made me sleepless. | Agree | 3 | 7 |
| 21 | John W | 28. I have been bothered with poor conscience because of shopping/buying. | Agree | 3 | 7 |
- Export patient responses including the calculated BSAS score and shopping addiction to Google Sheets for easy record-keeping
- Export individual points for 28 items to Google Sheets for data manipulation and analysis for comprehensive insights
- Use pre-built reports to easily keep track of patient progress over time and monitor changes in their shopping addiction symptoms
- Receive a copy of the response and the calculated BSAS score by email whenever a patient submits their BSAS assessment
- 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: | ****** |
| 1. Shopping/buying is the most important thing in my life.: | Agree |
| 2. I think about shopping/buying things all the time.: | Agree |
| 3. I spend a lot of time thinking of or planning shopping/buying.: | Agree |
| 4. Thoughts about shopping/buying keep popping in my head.: | Agree |
| 5. I shop in order to feel better.: | Agree |
| 6. I shop/buy things in order to change my mood.: | Agree |
| 7. I shop/buy things in order to forget about personal problems.: | Agree |
| 8. I shop/buy things in order to reduce feelings of guilt, anxiety, helplessness, loneliness, and/or depression.: | Agree |
| 9. I shop/buy so much that it negatively affects my daily obligations (e.g., school and work).: | Agree |
| 10. I give less priority to hobbies, leisure activities, job/studies, or exercise because of shopping/buying.: | Agree |
| 11. I have ignored love partner, family, and friends because of shopping/buying.: | Agree |
| 12. I often end up in arguments with other because of shopping/buying.: | Agree |
| 13. I feel an increasing inclination to shop/buy things.: | Agree |
| 14. I shop/buy much more than I had intended/planned.: | Agree |
| 15. I feel I have to shop/buy more and more to obtain the same satisfaction as before.: | Agree |
| 16. I spend more and more time shopping/buying.: | Agree |
| 17. I have tried to cut down on shopping/buying without success.: | Agree |
| 18. I have been told by others to reduce shopping/buying without listening to them.: | Agree |
| 27. I have worried so much about my shopping that it sometimes has made me sleepless.: | Agree |
| 28. I have been bothered with poor conscience because of shopping/buying.: | Agree |
| Total Score: | 88 |
| BSAS Score: | 7 |
| Shopping Addiction: | Yes |
| BSAS Score: | 7 |
| Shopping Addiction: | Yes |
- Create a HIPAA compliant BSAS assessment form to safely collect, store and access patient responses
- Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
- Automatically mask PHI fields when exporting BSAS form responses to Google Sheets and sending them on email
- Prepopulate patient details in BSAS assessments by creating secure prefill links without exposing PHI
- Limit access to patient data only for authorized personnel and minimize the risk of data breaches
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