GAD-7

GAD-7
Patient Name*

First NameLast Name
Today's Date*

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

Answer required for each row*

	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