Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.GAD – 7The questions below ask about how often and how severe you may experience anxiety symptoms over the past two weeks. Please help us provide you with the best medical care by answering the following questions.Date *Client Name *FirstLastFeeling nervous, anxious or on edge Selected Value: 0 0 – Not at all 1 – Several Days 2 – More than half the days 3 – Nearly every day Not being able to stop or control worrying Selected Value: 0 0 – Not at all 1 – Several Days 2 – More than half the days 3 – Nearly every day Worrying too much about different things Selected Value: 0 0 – Not at all 1 – Several Days 2 – More than half the days 3 – Nearly every day to sit Feeling Trouble relaxing Selected Value: 0 0 – Not at all 1 – Several Days 2 – More than half the days 3 – Nearly every day Being so restless that it is hard to sit still Selected Value: 0 0 – Not at all 1 – Several Days 2 – More than half the days 3 – Nearly every day Becoming easily annoyed or irritated Selected Value: 0 0 – Not at all 1 – Several Days 2 – More than half the days 3 – Nearly every day Feeling afraid as if something awful might happen Selected Value: 0 0 – Not at all 1 – Several Days 2 – More than half the days 3 – Nearly every day Total score of all your answers:If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? Selected Value: 0 0 – Not at all 1 – Somewhat difficult 2 – Very Difficult 3 – Extremely difficult When did the symptoms begin?Submit
