Staff use only. Enter the patient’s details below, then hand the tablet or laptop to the patient.
Patient Check-In · Staff
Enter the patient’s information to begin their My Mood Monitor.
FIRST NAME
LAST NAME
DATE OF BIRTH
MOBILE PHONE (optional)
🔒 Confidential: Patient identifiers entered here stay with the practice. Completed results are scored automatically and the clinical report is delivered securely to the care team. This check-in is not a medical diagnosis.
Please enter the patient’s first name, last name, and date of birth to continue.
🔒 HIPAA Compliant · Data is encrypted and secure
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My Mood Monitor
Dr. Nelson - Palmer Medical Clinic
Your check-in is private and goes only to your care team.Your honest answers help us care for you, better.
My Mood Monitor
🕒 3 Minutes
🔒 Secure
✓ 27 Questions
Welcome — this takes about 3 minutes and is completely confidential. When you are ready, tap below to begin.
Please note: This check-in is not a medical diagnosis. Your responses will be shared securely with Dr. Nelson to support your care. By tapping below, you acknowledge that your results may be used for clinical care coordination. Questions? Call us at (214) 702-2065.
📱 Texts from your doctor’s office: By tapping the button below, you say it’s OK for Dr. Nelson’s office to send you text messages about your health check-ins. The texts are free from us. Want them to stop? Just reply STOP to any text.
🔒 HIPAA Compliant · Your data is encrypted and secure
Step 1 of 290%
My Mood Monitor
Dr. Nelson - Palmer Medical Clinic
Over the last TWO WEEKS, have you noticed the following:
🔒 HIPAA Compliant · Your data is encrypted and secure
⌛
A brief reminder
These 4 questions are a little different.
Instead of the last two weeks, they ask about any time in your life — past or present — changes in energy, mood, or sleep.
Take a moment to think broadly before answering each one.
🔒 HIPAA Compliant · Your data is encrypted and secure
💙
Thank You for Sharing
It takes real honesty to acknowledge these feelings, even when they come up only rarely.
Your care team will review your responses and can talk with you whenever you are ready.
You are not alone in this.
Your answers will be shared securely with your care team, who are here to support you.
🔒 HIPAA Compliant · Your data is encrypted and secure
🧡
We Hear You
Feeling this way sometimes is worth paying attention to.
Talking about it can make a real difference. You do not have to face these feelings on your own.
Your care team is here for you.
Free support is available at 988 — call or text, any time.
🔒 HIPAA Compliant · Your data is encrypted and secure
🨆
Your Feelings Matter
Feeling this way often is something your care team needs to know about.
Please do not carry this alone.
988
Suicide & Crisis Lifeline — Call or Text — Free & Confidential
Your care team will follow up with you based on your answers today.
🔒 HIPAA Compliant · Your data is encrypted and secure
📞
You Are Not Alone
Whatever you are feeling right now — it matters, and support is available.
Free, confidential help is available 24 hours a day, 7 days a week.
988
Suicide & Crisis Lifeline
Call or Text — Free & Confidential
🔒 HIPAA Compliant · Your data is encrypted and secure
Dr. Nelson - Palmer Medical Clinic
Your check-in is private and goes only to your care team.Your honest answers help us care for you, better.
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✓
Thank You
My Mood Monitor Complete and Sent to Dr. Nelson - Palmer Medical Clinic.
Well Done.
What Happens Next
Dr. Nelson’s office will review your answers and if necessary reach out to you to discuss support options that are available.
If you have urgent concerns, contact your care team directly or dial 988 for immediate support.
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🔒 HIPAA Compliant · Your data is encrypted and secure