Title
FoRSE Progress Monitoring Survey
instrumentId
9V2A
Description
Instructions

Questions

Q1: Over the last 7 days, how many days have you used alcohol or other drugs?

 
Question Number Q1
Allow 'Not Answered'? Yes
Question Type pick_one
Answer Options pick_one
Value Text
0 0
1 1
2 2
3 3
4 4
5 5
6 6
7 7
Not Answered Not Answered

Q2: Over the last 7 days, how much were you bothered by cravings or urges to drink alcohol or use drugs?

 
Question Number Q2
Allow 'Not Answered'? Yes
Question Type pick_one
Answer Options pick_one
Value Text
1 1- Not at all bothered
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10- Very bothered
Not Answered Not Answered

Q3: How confident are you that you will be able to stay in recovery for the next 7 days or one week? (10 = very confident)

 
Question Number Q3
Allow 'Not Answered'? Yes
Question Type pick_one
Answer Options pick_one
Value Text
1 1- Not at all confident
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10- Very confident
Not Answered Not Answered

Q4: How much do you feel understood and supported by your counselor or primary caregiver?

 
Question Number Q4
Allow 'Not Answered'? Yes
Question Type pick_one
Answer Options pick_one
Value Text
1 1- Not at all supported and understood
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10- Very supported and understood
Not Answered Not Answered

Q5: To what extent do you feel that physical pain prevents you from doing what you need to do?

 
Question Number Q5
Allow 'Not Answered'? Yes
Question Type pick_one
Answer Options pick_one
Value Text
1 1- Not at all
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10 - An extreme amount
Not Answered Not Answered

Q6: Over the last 7 days, how much have you been troubled or bothered by psychological or emotional problems?

 
Question Number Q6
Allow 'Not Answered'? Yes
Question Type pick_one
Answer Options pick_one
Value Text
1 1- Not at all
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10 - An extreme amount
Not Answered Not Answered

Scoring

The scoring details below are for information only. The scoring for this survey happens on our side. Please do not provide survey scores.

JSON Instrument Definition for developers

{
    "instrumentId": "9V2A",
    "title": "FoRSE Progress Monitoring Survey",
    "description": "",
    "instructions": "",
    "questions": [
        {
            "assign_qnum": "y",
            "instrumentId": "9V2A",
            "include_in_export": "y",
            "allow_NotAnswered": "y",
            "question_status": "ACTIVE",
            "question_text": "Over the last 7 days, how many days have you used alcohol or other drugs?",
            "question_order": 1,
            "question_type": "pick_one",
            "textbox_max_chars": null,
            "textbox_input_type": null,
            "textbox_min_value": null,
            "textbox_max_value": null,
            "date_created": "2023-12-30 12:55:58",
            "qNum": "Q1",
            "answer_options": [
                {
                    "answer_text": "0",
                    "answer_order": 1,
                    "answer_severity": null,
                    "answer_value": "0.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "1",
                    "answer_order": 2,
                    "answer_severity": null,
                    "answer_value": "1.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "2",
                    "answer_order": 3,
                    "answer_severity": null,
                    "answer_value": "2.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "3",
                    "answer_order": 4,
                    "answer_severity": null,
                    "answer_value": "3.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "4",
                    "answer_order": 5,
                    "answer_severity": null,
                    "answer_value": "4.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "5",
                    "answer_order": 6,
                    "answer_severity": null,
                    "answer_value": "5.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "6",
                    "answer_order": 7,
                    "answer_severity": null,
                    "answer_value": "6.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "7",
                    "answer_order": 8,
                    "answer_severity": null,
                    "answer_value": "7.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_severity": null,
                    "answer_value": null,
                    "answer_text": "Not Answered",
                    "answer_status": "ACTIVE"
                }
            ]
        },
        {
            "assign_qnum": "y",
            "instrumentId": "9V2A",
            "include_in_export": "y",
            "allow_NotAnswered": "y",
            "question_status": "ACTIVE",
            "question_text": "Over the last 7 days, how much were you bothered by cravings or urges to drink alcohol or use drugs?",
            "question_order": 2,
            "question_type": "pick_one",
            "textbox_max_chars": null,
            "textbox_input_type": null,
            "textbox_min_value": null,
            "textbox_max_value": null,
            "date_created": "2023-12-30 12:55:58",
            "qNum": "Q2",
            "answer_options": [
                {
                    "answer_text": "1- Not at all bothered",
                    "answer_order": 1,
                    "answer_severity": null,
                    "answer_value": "1.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "2",
                    "answer_order": 2,
                    "answer_severity": null,
                    "answer_value": "2.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "3",
                    "answer_order": 3,
                    "answer_severity": null,
                    "answer_value": "3.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "4",
                    "answer_order": 4,
                    "answer_severity": null,
                    "answer_value": "4.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "5",
                    "answer_order": 5,
                    "answer_severity": null,
                    "answer_value": "5.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "6",
                    "answer_order": 6,
                    "answer_severity": null,
                    "answer_value": "6.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "7",
                    "answer_order": 7,
                    "answer_severity": null,
                    "answer_value": "7.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "8",
                    "answer_order": 8,
                    "answer_severity": null,
                    "answer_value": "8.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "9",
                    "answer_order": 9,
                    "answer_severity": null,
                    "answer_value": "9.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "10- Very bothered",
                    "answer_order": 10,
                    "answer_severity": null,
                    "answer_value": "10.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_severity": null,
                    "answer_value": null,
                    "answer_text": "Not Answered",
                    "answer_status": "ACTIVE"
                }
            ]
        },
        {
            "assign_qnum": "y",
            "instrumentId": "9V2A",
            "include_in_export": "y",
            "allow_NotAnswered": "y",
            "question_status": "ACTIVE",
            "question_text": "How confident are you that you will be able to stay in recovery for the next 7 days or one week? (10 = very confident)",
            "question_order": 3,
            "question_type": "pick_one",
            "textbox_max_chars": null,
            "textbox_input_type": null,
            "textbox_min_value": null,
            "textbox_max_value": null,
            "date_created": "2023-12-30 12:55:58",
            "qNum": "Q3",
            "answer_options": [
                {
                    "answer_text": "1- Not at all confident",
                    "answer_order": 1,
                    "answer_severity": null,
                    "answer_value": "1.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "2",
                    "answer_order": 2,
                    "answer_severity": null,
                    "answer_value": "2.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "3",
                    "answer_order": 3,
                    "answer_severity": null,
                    "answer_value": "3.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "4",
                    "answer_order": 4,
                    "answer_severity": null,
                    "answer_value": "4.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "5",
                    "answer_order": 5,
                    "answer_severity": null,
                    "answer_value": "5.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "6",
                    "answer_order": 6,
                    "answer_severity": null,
                    "answer_value": "6.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "7",
                    "answer_order": 7,
                    "answer_severity": null,
                    "answer_value": "7.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "8",
                    "answer_order": 8,
                    "answer_severity": null,
                    "answer_value": "8.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "9",
                    "answer_order": 9,
                    "answer_severity": null,
                    "answer_value": "9.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "10- Very confident",
                    "answer_order": 10,
                    "answer_severity": null,
                    "answer_value": "10.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_severity": null,
                    "answer_value": null,
                    "answer_text": "Not Answered",
                    "answer_status": "ACTIVE"
                }
            ]
        },
        {
            "assign_qnum": "y",
            "instrumentId": "9V2A",
            "include_in_export": "y",
            "allow_NotAnswered": "y",
            "question_status": "ACTIVE",
            "question_text": "How much do you feel understood and supported by your counselor or primary caregiver?",
            "question_order": 4,
            "question_type": "pick_one",
            "textbox_max_chars": null,
            "textbox_input_type": null,
            "textbox_min_value": null,
            "textbox_max_value": null,
            "date_created": "2023-12-30 12:55:58",
            "qNum": "Q4",
            "answer_options": [
                {
                    "answer_text": "1- Not at all supported and understood",
                    "answer_order": 1,
                    "answer_severity": null,
                    "answer_value": "1.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "2",
                    "answer_order": 2,
                    "answer_severity": null,
                    "answer_value": "2.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "3",
                    "answer_order": 3,
                    "answer_severity": null,
                    "answer_value": "3.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "4",
                    "answer_order": 4,
                    "answer_severity": null,
                    "answer_value": "4.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "5",
                    "answer_order": 5,
                    "answer_severity": null,
                    "answer_value": "5.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "6",
                    "answer_order": 6,
                    "answer_severity": null,
                    "answer_value": "6.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "7",
                    "answer_order": 7,
                    "answer_severity": null,
                    "answer_value": "7.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "8",
                    "answer_order": 8,
                    "answer_severity": null,
                    "answer_value": "8.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "9",
                    "answer_order": 9,
                    "answer_severity": null,
                    "answer_value": "9.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "10- Very supported and understood",
                    "answer_order": 10,
                    "answer_severity": null,
                    "answer_value": "10.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_severity": null,
                    "answer_value": null,
                    "answer_text": "Not Answered",
                    "answer_status": "ACTIVE"
                }
            ]
        },
        {
            "assign_qnum": "y",
            "instrumentId": "9V2A",
            "include_in_export": "y",
            "allow_NotAnswered": "y",
            "question_status": "ACTIVE",
            "question_text": "To what extent do you feel that physical pain prevents you from doing what you need to do?",
            "question_order": 5,
            "question_type": "pick_one",
            "textbox_max_chars": null,
            "textbox_input_type": null,
            "textbox_min_value": null,
            "textbox_max_value": null,
            "date_created": "2023-12-30 12:55:58",
            "qNum": "Q5",
            "answer_options": [
                {
                    "answer_text": "1- Not at all",
                    "answer_order": 1,
                    "answer_severity": null,
                    "answer_value": "1.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "2",
                    "answer_order": 2,
                    "answer_severity": null,
                    "answer_value": "2.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "3",
                    "answer_order": 3,
                    "answer_severity": null,
                    "answer_value": "3.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "4",
                    "answer_order": 4,
                    "answer_severity": null,
                    "answer_value": "4.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "5",
                    "answer_order": 5,
                    "answer_severity": null,
                    "answer_value": "5.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "6",
                    "answer_order": 6,
                    "answer_severity": null,
                    "answer_value": "6.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "7",
                    "answer_order": 7,
                    "answer_severity": null,
                    "answer_value": "7.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "8",
                    "answer_order": 8,
                    "answer_severity": null,
                    "answer_value": "8.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "9",
                    "answer_order": 9,
                    "answer_severity": null,
                    "answer_value": "9.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "10 - An extreme amount",
                    "answer_order": 10,
                    "answer_severity": null,
                    "answer_value": "10.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_severity": null,
                    "answer_value": null,
                    "answer_text": "Not Answered",
                    "answer_status": "ACTIVE"
                }
            ]
        },
        {
            "assign_qnum": "y",
            "instrumentId": "9V2A",
            "include_in_export": "y",
            "allow_NotAnswered": "y",
            "question_status": "ACTIVE",
            "question_text": "Over the last 7 days, how much have you been troubled or bothered by psychological or emotional problems?",
            "question_order": 6,
            "question_type": "pick_one",
            "textbox_max_chars": null,
            "textbox_input_type": null,
            "textbox_min_value": null,
            "textbox_max_value": null,
            "date_created": "2023-12-30 12:55:58",
            "qNum": "Q6",
            "answer_options": [
                {
                    "answer_text": "1- Not at all",
                    "answer_order": 1,
                    "answer_severity": null,
                    "answer_value": "1.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "2",
                    "answer_order": 2,
                    "answer_severity": null,
                    "answer_value": "2.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "3",
                    "answer_order": 3,
                    "answer_severity": null,
                    "answer_value": "3.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "4",
                    "answer_order": 4,
                    "answer_severity": null,
                    "answer_value": "4.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "5",
                    "answer_order": 5,
                    "answer_severity": null,
                    "answer_value": "5.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "6",
                    "answer_order": 6,
                    "answer_severity": null,
                    "answer_value": "6.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "7",
                    "answer_order": 7,
                    "answer_severity": null,
                    "answer_value": "7.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "8",
                    "answer_order": 8,
                    "answer_severity": null,
                    "answer_value": "8.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "9",
                    "answer_order": 9,
                    "answer_severity": null,
                    "answer_value": "9.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_text": "10 - An extreme amount",
                    "answer_order": 10,
                    "answer_severity": null,
                    "answer_value": "10.00",
                    "answer_status": "ACTIVE",
                    "date_created": "2023-12-30 12:55:29"
                },
                {
                    "answer_severity": null,
                    "answer_value": null,
                    "answer_text": "Not Answered",
                    "answer_status": "ACTIVE"
                }
            ]
        }
    ]
}

Example Push for developers

URL Endpoint:

https://naatpdata.com/v2/api/surveys.php

Authentication

$FACILITY_ID = '123DEMO'; Provided By Us
$SECRET_KEY = 'aaaaaabbbbbbbbccccccccdddddddeeeeeefffffgggggg'; Provided By Us
$API_DATE = gmdate( time() ); Current UNIX UTC time = 1720278076
$API_SIGNATURE = hash_hmac('sha256', $API_DATE . $FACILITY_ID, $SECRET_KEY); a53a40e3d216c3550498030e5cf1cafb1f1837d4dfaf57d5b09262da9f6dc360
 

Complete Post

{
    "facilityId": "123DEMO",
    "apiDate": "1720278076",
    "apiSignature": "a53a40e3d216c3550498030e5cf1cafb1f1837d4dfaf57d5b09262da9f6dc360",
    "surveys": [
        {
            "instrumentId": "9V2A",
            "sessionId": "123session",
            "clientId": "123client",
            "assignedToType": "Client",
            "yearOfAdmit": "2023",
            "yearCompleted": "2023",
            "daysFromAdmit": -99,
            "daysFromDischarge": 180,
            "completedWhile": "postDischarge",
            "answerStyle": "byText",
            "Q1": "4",
            "Q2": "2",
            "Q3": "2",
            "Q4": "6",
            "Q5": "6",
            "Q6": "4"
        },
        {
            "instrumentId": "9V2A",
            "sessionId": "123session",
            "clientId": "123client",
            "assignedToType": "Client",
            "yearOfAdmit": "2023",
            "yearCompleted": "2023",
            "daysFromAdmit": 30,
            "daysFromDischarge": -99,
            "completedWhile": "inTreatment",
            "answerStyle": "byValue",
            "Q1": "Not Answered",
            "Q2": "Not Answered",
            "Q3": 3,
            "Q4": 6,
            "Q5": 10,
            "Q6": 4
        }
    ]
}