Run Trauma-Informed Care Screening Checklist — Free

Screening Workflow and Consent

Trauma screening is offered in a private, respectful setting critical (required)

Confirm the screening occurs where the patient can speak confidentially without interruption or exposure to other patients.

Yes No N/A

Patient informed of purpose, limits, and voluntary nature of screening critical (required)

Verify staff explain why the screening is being asked, how the information will be used, and any limits to confidentiality.

Yes No N/A

Consent or refusal is documented before trauma history questions are asked critical (required)

Check that the record shows consent to proceed or a documented refusal/deferral when the patient declines.

Yes No N/A

Screening tool used matches approved workflow or SOP

Confirm the staff member used the approved trauma-informed screening tool, script, or intake workflow for the setting.

Yes No N/A

Screening was completed by trained staff

Verify the person conducting the screening has current training in trauma-informed communication and de-escalation.

Yes No N/A

Trauma History Documentation

Trauma history screening result is documented in the record critical (required)

Confirm the chart includes whether trauma exposure was disclosed, declined, deferred, or not indicated.

Relevant trauma triggers or stressors are documented when disclosed

Check that known triggers, reminders, or stressors that may affect care are recorded in a clinically appropriate manner.

Yes No N/A

Patient preferences for communication and touch are documented

Verify the record includes preferences such as preferred name/pronouns, permission before touch, pacing, or communication style.

Yes No N/A

Any immediate safety concerns identified during screening are documented and escalated critical (required)

Confirm urgent concerns such as self-harm risk, abuse, or imminent safety issues were documented and escalated per protocol.

Yes No N/A

Documentation avoids unnecessary detail that could retraumatize or compromise privacy

Review whether notes are clinically sufficient without excessive narrative detail that is not needed for care.

Yes No N/A

Trauma-Sensitive Accommodations

Accommodations were offered based on patient needs or preferences critical (required)

Confirm the patient was offered reasonable trauma-sensitive accommodations such as breaks, support person presence, or modified pacing.

Yes No N/A

Environment supports emotional and physical safety

Verify the setting is calm, private, and arranged to reduce distress where possible.

Patient was offered choice and control during the encounter

Check whether the patient could pause, decline questions, choose seating, or otherwise control the pace of the interaction.

Yes No N/A

Interpreter, support person, or other communication support was provided when needed

Confirm accommodations were made for language access, disability access, or support person involvement when indicated.

Yes No N/A

Staff used trauma-sensitive language and avoided re-traumatizing prompts critical (required)

Observe whether staff used respectful, nonjudgmental language and avoided pressing for unnecessary details.

Yes No N/A

Clinical Follow-Up and Care Planning

Follow-up assessment was scheduled or completed when screening indicated need critical (required)

Verify that positive or concerning screening results triggered a follow-up assessment, referral, or care plan update.

Yes No N/A

Referrals or next steps were documented when clinically indicated

Check for referrals to behavioral health, crisis services, social work, advocacy, or other appropriate resources.

Yes No N/A

Safety plan or escalation pathway documented when risk was identified critical (required)

Confirm that any identified risk led to a documented safety plan, crisis response, or escalation per policy.

Yes No N/A

Care plan reflects trauma-informed adjustments

Review whether the care plan includes adjustments such as pacing, visit structure, communication preferences, or trigger avoidance.

Yes No N/A

Staff Competency, Quality, and Sign-Off

Staff demonstrated trauma-informed communication and de-escalation competency

Assess whether the staff member demonstrated appropriate tone, pacing, empathy, and de-escalation skills during the encounter.

Any deficiencies or non-conformances were documented with corrective action

Record observed gaps, the immediate corrective action, and the responsible party for follow-up.

Yes No N/A

Inspector signature critical (required)

Signature of the reviewer completing this inspection.

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Run: Trauma-Informed Care Screening Checklist

Screening Workflow and Consent

Trauma History Documentation

Trauma-Sensitive Accommodations

Clinical Follow-Up and Care Planning

Staff Competency, Quality, and Sign-Off

Get your results