Generalized Anxiety Disorder 7-item (GAD-7) scale
Name
*
First Name
Last Name
Date
*
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Month
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Day
Year
Date
Over the last 2 weeks, how often have you beenbothered by the following problems?
Score
Feeling nervous, anxious, or on edge
0 - Not at all sure
1- Several days
2- Over half the days
3 - Nearly every day
Not being able to stop or control worrying
0 - Not at all sure
1- Several days
2- Over half the days
3 - Nearly every day
Worrying too much about different things
0 - Not at all sure
1- Several days
2- Over half the days
3 - Nearly every day
Trouble relaxing
0 - Not at all sure
1- Several days
2- Over half the days
3 - Nearly every day
Being so restless that it's hard to sit still
0 - Not at all sure
1- Several days
2- Over half the days
3 - Nearly every day
Becoming easily annoyed or irritable
0 - Not at all sure
1- Several days
2- Over half the days
3 - Nearly every day
Feeling afraid as if something awful might happen
0 - Not at all sure
1- Several days
2- Over half the days
3 - Nearly every day
Add the score and input below:
*
If you checked off any problems, how difficult have these made it for you to do your work, take care of things at home, or get along with other people?
Not difficult at all
Somewhat difficult
Very difficult
Extremely difficult
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