GAD - 7
Name
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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 been bothered by any of the following problems? Type the point value for your choice in each question and leave the other boxes for that question blank. For example, if you chose "several days" for question 2, type a 1 in that box and leave the others blank.
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Not at all
0 points each
Several Days
1 point each
More than half the days
2 points each
Nearly every day
3 points each
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 bad might happen
Add up the 4 columns and put your answer here:
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Submit
Should be Empty: