Generalized Anxiety Disorder Screener (GAD-7)

Generalized Anxiety Disorder Screener (GAD-7)
Today's Date

MonthDayYear
Patient Name
Date of Birth

MonthDayYear
Over the last 2 weeks, how often have you been bothered by the following problems?
Feeling nervous anxious or on edge

Not at allSeveral DaysMore than half the daysNearly every day
Not being able to stop or control worrying

Not at allSeveral DaysMore than half the daysNearly every day
Worrying too much about different things

Not at allSeveral DaysMore than half the daysNearly every day
Trouble relaxing

Not at allSeveral DaysMore than half the daysNearly every day
Being so restless that it is hard to sit still

Not at allSeveral DaysMore than half the daysNearly every day
Becoming easily annoyed or irritated

Not at allSeveral DaysMore than half the daysNearly every day
Feeling afraid as if something awful might happen

Not at allSeveral DaysMore than half the daysNearly every day
Total Score
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?

Not difficult at allSome what difficultVery difficultExtremely difficult
When did the symptoms begin?
Should be Empty: