CalTMS - PHQ-9

1

First, please tell us your name.* This field is required.All information is securely stored and confidential.

First Name

Last Name

2

Your Cell Number* This field is required.Used to verify your health record

Please enter a valid phone number.

3

Over the past 2 weeks, how often have you experienced the following?* This field is required.Little interest or pleasure in doing things

Nearly every day

More than half the days

Several days

Not at all

4

Feeling down, depressed, or hopeless* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

5

Trouble falling or staying asleep, or sleeping too much* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

6

Feeling tired or having little energy* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

7

Poor appetite or overeating* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

8

Feeling bad about yourself...or that you are a failure or have let yourself or your family down* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

9

Trouble concentrating on things, such as reading, or watching television* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

10

Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

11

Thoughts that you would be better off dead, or of hurting yourself* This field is required.Over the past 2 weeks, how often have you experienced the above?

Nearly every day

More than half the days

Several days

Not at all

12

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?* This field is required.Last question for the Depression Quiz.

Extremely difficult

Very difficult

Somewhat difficult

Not difficult at all

13

Results of your PHQ-9The Patient Health Questionnaire (9 questioons) is designed for Depression

Out of 27. Based on PHQ-9.

14

Sliders with calculated result

15

No symptoms of depressionYour score suggests you may not need depression treatment. Consult with your physician if symptoms arise.

16

Minimal depressionYour score suggests you may not need depression treatment. Consult with your physician if symptoms persist.

17

Minimal depressionYour score suggests you may not need depression treatment. Consult with your physician if symptoms persist.

18

Minimal depressionYour score suggests you may not need depression treatment. Consult with your physician if symptoms persist.

19

Minimal depressionYour score suggests you may not need depression treatment. Consult with your physician if symptoms persist.

20

Mild depressionYour score suggests you should speak in depth with your physician and/or psychiatrist to assess further.

21

Mild depressionYour score suggests you should speak in depth with your physician and/or psychiatrist to assess further.

22

Mild depressionYour score suggests you should speak in depth with your physician and/or psychiatrist to assess further.

23

Mild depressionYour score suggests you should speak in depth with your physician and/or psychiatrist to assess further.

24

Mild depressionYour score suggests you should speak in depth with your physician and/or psychiatrist to assess further.

25

Moderate depressionYour score suggests you should speak in depth with a psychiatrist to find a treatment that works for you.

26

Moderate depressionYour score suggests you should speak in depth with a psychiatrist to find a treatment that works for you.

27

Moderate depressionYour score suggests you should speak in depth with a psychiatrist to find a treatment that works for you.

28

Moderate depressionYour score suggests you should speak in depth with a psychiatrist to find a treatment that works for you.

29

Moderate depressionYour score suggests you should speak in depth with a psychiatrist to find a treatment that works for you.

30

Moderately severe depressionYour score warrants treatment for depression, using antidepressant, therapy or a combination of treatment. If medication and therapy haven't helped, you should consider an interventional treatment like TMS and/or Ketamine/Esketamine.

31

Moderately severe depressionYour score warrants treatment for depression, using antidepressant, therapy or a combination of treatment. If medication and therapy haven't helped, you should consider an interventional treatment like TMS and/or Ketamine/Esketamine.

32

Moderately severe depressionYour score warrants treatment for depression, using antidepressant, therapy or a combination of treatment. If medication and therapy haven't helped, you should consider an interventional treatment like TMS and/or Ketamine/Esketamine.

33

Moderately severe depressionYour score warrants treatment for depression, using antidepressant, therapy or a combination of treatment. If medication and therapy haven't helped, you should consider an interventional treatment like TMS and/or Ketamine/Esketamine.

34

Moderately severe depressionYour score warrants treatment for depression, using antidepressant, therapy or a combination of treatment. If medication and therapy haven't helped, you should consider an interventional treatment like TMS and/or Ketamine/Esketamine.