Generalized Anxiety Screener (GAD-7)
Name
*
First Name
Last Name
Today's Date
*
-
Year
-
Month
Day
Date
Over the last 2 weeks, how often have you been bothered by the following problems?
Rows
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 irritable
7. Feeling afraid as if something awful might happen
Rows
Not difficult at all
Somewhat difficult
Very
difficult
Extremely
difficult
8. If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
When did the symptoms begin?
Please type your response above
Submit
For use by a healthcare professional:
GAD-7 Score 0-5 Minimal 6-10 Mild 11-15 Moderate 16-21 Severe
Should be Empty: