Anxiety GAD-7

Name*

First Last

Date*

Date of Birth*

Clinician*

Over the last 2 weeks, how often have you been bothered by the following problems?

Feeling nervous, anxious or on edge*

Not at all
Several days
More than half the days
Nearly every day

Not being able to stop or control worrying*

Not at all
Several days
More than half the days
Nearly every day

Worrying too much about different things*

Not at all
Several days
More than half the days
Nearly every day

Trouble relaxing*

Not at all
Several days
More than half the days
Nearly every day

Being so restless that it is hard to sit still*

Not at all
Several days
More than half the days
Nearly every day

Becoming easily annoyed or irritable*

Not at all
Several days
More than half the days
Nearly every day

Feeling afraid as if something awful might happen*

Not at all
Several days
More than half the days
Nearly every day

If you checked off any problems, 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 all
Somewhat  difficult
Very difficult
Extremely difficult

Anxiety (GAD-7)

Over the last 2 weeks, how often have you been bothered by the following problems?

Patients and Visitors

Work With Us

About Us

GP and Clinician Area