GAD7

General Anxiety Disorder 7-item (GAD-7) Scale

Patient's Name *

First Name Last Name

Date *

Date

Over the last 2 weeks, how often have you been bothered by the following problems? *

Not at all sure (0)

Several Days (1)

Over 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

Total Score

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

Source: Spitzer RL, Kroenke K, Williams JBW, Lowe B. A brief measure for assessing generalized anxiety disorder. Arch Inern Med. 2006;166:1092-1097.