Generalized Anxiety Disorder Questionnaire (GAD-7)
Date
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Over the last 2 weeks, how often have you been bothered by the following problems?
1. Feeling nervous, anxious, or on edge.
*
Not at all
Several days
Over half the days
Nearly every day
2. Not being able to stop or control worrying.
*
Not at all
Several days
Over half the days
Nearly every day
3. Worrying too much about different things.
*
Not at all
Several days
Over half the days
Nearly every day
4. Trouble relaxing.
*
Not at all
Several days
Over half the days
Nearly every day
5. Being so restless that it's hard to sit still.
*
Not at all
Several days
Over half the days
Nearly every day
6. Becoming easily annoyed or irritable.
*
Not at all
Several days
Over half the days
Nearly every day
7. Feeling afraid as if something awful might happen.
*
Not at all
Several days
Over half the days
Nearly every day
If you checked off any problems, how difficult have these made it for you to do your work, take care of things at home, or get along with other people?
*
Not difficult at all
Somewhat difficult
Very difficult
Extremely difficult
GAD-7 Total Score:
GAD-7 Severity
Would you like to be contacted for a free 10-minute initial consultation?
*
Yes
No
Submit
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