Beck Depression Inventory

Beck Depression Inventory

Please complete all questions on this form based on the last 2 weeks
Name

First Name Last Name
Date Of Birth

Month Day Year
Date
Q1 *
Q2 *
Q3 *
Q4 *
Q5 *
Q6 *
Q7 *
Q8 *
Q9 *
Q10 *
Q11 *
Q12 *
Q13 *
Q14 *
Q15 *
Q16 *
Q17 *
Q18 *
Q19 *
Q20 *
Q21
1-10: These ups and downs are considered normal

11-16: - Mild mood disturbance

17-20: Borderline clinical depression

21-30: Moderate depression

31-40: Severe depression

over 40: Extreme depression
Score
Should be Empty: