Bergen Shopping Addiction Scale
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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
  • navigate_next Prebuilt template with BSAS scoring to assess the presence of shopping addiction and measure its severity
  • navigate_next 28-item questionnaire that scores each item from “0” (completely disagree) to “4” (completely agree)
  • navigate_next Real-time calculation of BSAS Score and shopping addiction based on the form responses
  • navigate_next Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
  • navigate_next Compare the scores from the initial screening with that of the followup to track the progression of shopping addiction
  • navigate_next 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
  • navigate_next Pre-populate patient details such as patient id, name, email etc in the BSAS assessment form before sharing it with the patients
  • navigate_next Send an email invitation with a secure link for patients to complete their BSAS assessment form prior to their visit
  • navigate_next Allow patients to save their progress and complete their BSAS assessment form at a later time without losing any responses
  • navigate_next Set up an email template for your BSAS assessment and automatically send invitation emails to multiple patients with ease
  • navigate_next 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
  • navigate_next Export patient responses including the calculated BSAS score and shopping addiction to Google Sheets for easy record-keeping
  • navigate_next Export individual points for 28 items to Google Sheets for data manipulation and analysis for comprehensive insights
  • navigate_next Use pre-built reports to easily keep track of patient progress over time and monitor changes in their shopping addiction symptoms
  • navigate_next Receive a copy of the response and the calculated BSAS score by email whenever a patient submits their BSAS assessment
  • navigate_next 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
  • navigate_next Create a HIPAA compliant BSAS assessment form to safely collect, store and access patient responses
  • navigate_next Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
  • navigate_next Automatically mask PHI fields when exporting BSAS form responses to Google Sheets and sending them on email
  • navigate_next Prepopulate patient details in BSAS assessments by creating secure prefill links without exposing PHI
  • navigate_next Limit access to patient data only for authorized personnel and minimize the risk of data breaches

These reviews are reproduced without modification from Google Workspace Marketplace.

July 23, 2023

5 stars

I am not tech savvy. I chose formesign to help create registration links for clients. Vipid has been great in assisting me. He goes above and beyond. My company now has moved from the stone age to modern age through the ability to use this feature. Of the many features I am impressed with, the ability to update a form without needing to regenerate a link is amazing. I often make mistakes and that ability allows me to fix mistakes without needing to change everything. Thank you!!!

— Sol Evans

February 16, 2024

1 stars

Does not work

— Myles Sicuro

October 31, 2023

5 stars

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July 12, 2023

5 stars

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November 27, 2023

5 stars

Yeah this is good for all

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July 10, 2023

5 stars

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