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GAD-7
To be completed by patient.
Patient Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Over the past 2 WEEKS, how often have you been bothered by the following problems?
*
Rows
Not at All
Several Days
More than half the days
Nearly every day
Feeling nervous, anxious, or on edge
Not being able to stop or control worrying
Worrying too much about different things
Trouble relaxing
Being so restless that it's hard to sit still
Becoming easily annoyed or irritable
Feeling afraid as if something awful might happen
Score
Submit
Should be Empty: