Generalized Anxiety Disorder 7-item (GAD-7) scale
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Over the last 2 weeks, how often have you beenbothered by the following problems?
*
Not at all
0
Several days
1
More than half the days
2
Nearly every day
3
1. Feeling nervous, anxious, or on edge
2. Not being able to stop or control worrying
3. Worrying too much about different things
4. Trouble relaxing
5.Being so restless that it's hard to sit still
6. Becoming easily annoyed or irritable
7. Feeling afraid as if something awful might
happen
Add the score for each colunm______+_____+_____+
_____
Total Score (add your column scores)=_______
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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