Generalized Anxiety Disorder 7-item
(GAD-7) Scale
Date:
*
.
Year
.
Month
Day
Date
Name
*
First Name
Last Name
TUWell Provider:
*
Over the last 2 weeks, how often have you been bothered by the following problems?
*
Not at all
Several days
More than half the days
Nearly every day
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 is hard to sit still
6. Becoming easily annoyed or irritated
7. Feeling afraid as if something awful might happen
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
When did the symptoms begin?
Total Score:
Submit
Should be Empty: