GAD-7
Generalized Anxiety Disorder Self Report Questionaire
Name
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First Name
Last Name
Date Completed
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Month
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Day
Year
Date
Date of Birth
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Month
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Day
Year
Date
Over the last 2 weeks, how often have you been bothered by the following problems?
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
Submit
GAD-7 Score (0-5 Minimal) (6-10 Mild) (11-15 Moderate) (16-21 Severe)
Should be Empty: