Website Depression Screener

Are You Depressed?

September is Suicide Awareness Month, and we want to take this time to remind you that mental health is just as important as physical health. Depression can affect anyone—regardless of age, background, or life situation—and sometimes it can be hard to notice the signs in ourselves.As part of our commitment to supporting your well-being, we are inviting all of our patients to complete a short, confidential wellness check (the PHQ-9 questionnaire). This quick screening helps us understand how you are feeling and allows our team to reach out if you may need additional care or simply someone to talk to.Your responses will only be used to guide your care and connect you with support if needed. Please take a few minutes to complete it here:Remember, you are not alone. If you are ever in crisis, please call 988 or call our office at 212-707-8662
Today's date*

MonthDayYear
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
What is your primary insurance?*
How did you hear about APP Health Group *
Other:*
Over the last two weeks, how often have you been bothered by the following problems?
1. Little interest or pleasure in doing things*

Not at allSeveral DaysMore than half the daysNearly every day
2. Feeling down, depressed or hopeless*

Not at allSeveral DaysMore than half the daysNearly every day
3. Trouble falling or staying asleep, sleeping too much*

Not at allSeveral DaysMore than half the daysNearly every day
4. Feeling tired or having little energy*

Not at allSeveral DaysMore than half the daysNearly every day
5. Poor appetite or overeating*

Not at allSeveral DaysMore than half the daysNearly every day
6. Feeling bad about yourself-or that you are a failure or have let yourself or your family down*

Not at allSeveral DaysMore than half the daysNearly every day
7. Trouble concentrating on things, such as reading the newspaper or watching television*

Not at allSeveral DaysMore than half the daysNearly every day
8. Moving or speaking so slowly that other people could have noticed. Or the opposite-being so figety or restless that you have been moving around a lot more than usual*

Not at allSeveral DaysMore than half the daysNearly every day
9. Thoughts that you would be better off dead, or of hurting yourself*

Not at allSeveral DaysMore than half the daysNearly every day
PHQ-9 Calculation
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 allSomewhat difficultVery difficultExtremely difficult
How many anti-depressant medications do you currently take or have tried in the past?

012345+
Should be Empty:

Are You Depressed?

Over the last two weeks, how often have you been bothered by the following problems?