Self-check: notes for a clinician
Putting experiences into words can be hard in a short appointment. Use this private checklist to note what you have noticed, add examples, and choose questions to ask. Then print or save it and bring it with you.
Not a test or a diagnosis
There is no score here. Borderline personality disorder is diagnosed by a licensed mental health professional after a thorough discussion of symptoms and history, and a medical exam can rule out other causes.
National Institute of Mental Health · Borderline personality disorder (brochure)
Private by design
Your answers stay in this browser tab. Nothing is stored, sent, or tracked, and closing or reloading the page clears them. Only you can print or save a copy.
Crisis help is always here
Some items ask about self-harm and suicide. Crisis contacts stay on screen the whole time, and you can call or text 988 at any time.
Notes for a clinician
What you have noticed
Your notes
To bring to a clinician
This is not a test. It gives no score and cannot tell you whether you have borderline personality disorder or any other condition. Only a licensed mental health professional can make a diagnosis, after a full assessment.
Things I have noticed
Nothing checked yet.
Questions I want to ask
- Could borderline personality disorder, another condition, or more than one condition explain what I am experiencing?
- Can I have a full assessment, or a referral to a mental health professional who can do one?
- Could we use a questionnaire to measure my symptoms now and track changes during treatment?
- Which structured therapies for borderline personality disorder are available near me, and how long do they last?
- Can we write a treatment plan and a crisis plan together?
- If a medicine is suggested, what specific symptom is it for, and when will we review it?
- How could my family or friends be involved, if I want them to be?
Print and save turn on once you check an item or write a note. Print opens your print dialog, where you can also choose Save as PDF. Save notes downloads a small text file. Nothing is stored or sent, and reloading the page clears everything.
What to do next
Take your notes to a provider
Book a visit
A primary care provider can refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker.
National Institute of Mental Health · Borderline personality disorder (brochure)
Learn how diagnosis works
What a full assessment covers, why there is no single test, and how other conditions are considered.
Track a week
Providers ask how strong symptoms are and how often they happen. A weekly diary card makes those answers easier.
National Institute of Mental Health · Tips for talking with a health care provider
About these notes
Why this is not a scored questionnaire
The statements on this page restate the symptom list published by the National Institute of Mental Health, in the first person. They are not a validated questionnaire, so the page does not count your answers or suggest what they mean.
The American Psychiatric Association suggests that a first evaluation include a quantitative measure, such as a questionnaire or rating scale, to find out how severe symptoms are and how much they affect daily life. Your clinician can choose one and help you interpret it.
One validated screener is the McLean Screening Instrument for Borderline Personality Disorder, a 10-item self-report questionnaire. In its first study of 200 adults with a history of mental health treatment, a cutoff of 7 or more of the 10 items correctly flagged 81% of people who had the disorder and correctly cleared 85% of those who did not. A positive screen means a fuller assessment is needed, not a diagnosis.
The questionnaire is copyrighted and distributed through the ePROVIDE licensing service. We could not confirm permission to reproduce it on a public website, so it is not included here. You can ask a clinician about it.