Anxiety Symptoms Questionnaire

Anxiety Symptoms Questionnaire - GAD-7
Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Email
example@example.com
Over the last 2 weeks, how often have you been bothered by the following problems? (Use “✔” to indicate your answer)
Feeling nervous, anxious or on edge
Not being able to stop or control worrying
Worrying too much about different things
Trouble relaxing
Being so restless that it is hard to sit still
Becoming easily annoyed or irritable
Feeling afraid as if something awful might happen
Please verify that you are human
Should be Empty:

Anxiety Symptoms Questionnaire - GAD-7