assessment tool

[jasminmostafa8888-max]

Create a complete HTML + JavaScript psychological screening form for hospital admitted adult patients.

The form must include:

1. WHO-5 Well-Being Index questions
2. HADS Anxiety and Depression scale structure

Important:

• Do not include copyrighted HADS questions word-for-word.
• Use placeholders like “HADS-A Item 1” and “HADS-D Item 1” so I can replace them with the official licensed wording.

Design requirements:

• Professional hospital style
• Mobile responsive
• One-page HTML file
• Clean CSS included inside the file
• Patient information section:
  MRN, Unit, Age, Gender, Isolation Type, Date
• Consent checkbox before starting
• Likert scale radio buttons
• Automatic scoring using JavaScript
• WHO-5 score:
  Sum raw score 0–25, then multiply by 4 to give percentage
• HADS:
  Anxiety score = 7 items
  Depression score = 7 items
  Each item scored 0–3
• Interpretation:
  WHO-5 ≤ 50 = Poor well-being
  HADS-A ≥ 8 = Possible anxiety
  HADS-D ≥ 8 = Possible depression
• Risk level:
  Green = normal
  Yellow = moderate concern
  Red = high concern / psychological follow-up recommended
• Add nurse observation section:
  Observed mood, sleep disturbance, appetite changes, social withdrawal, suicide concern observed Yes/No
• If suicide concern is Yes, show alert:
  “Immediate clinical escalation and C-SSRS assessment recommended.”
• Add buttons:
  Calculate score
  Reset form
  Print report
  Export responses to CSV
• Show final summary report after calculation.

Return the full HTML code only.

[jasminmostafa8888-max]

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