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Patient Health Questionnaire (PHQ-9)

Patient Health Questionnaire (PHQ-9)

"*" indicates required fields

Name*
DD slash MM slash YYYY

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

Little interest or pleasure in doing things?*
Feeling down, depressed, or hopeless?*
Trouble falling or staying asleep, or sleeping too much?*
Feeling tired or having little energy?*
Poor appetite or overeating?*
Feeling bad about yourself - or that you are a failure or have let yourself or your family down?*
Trouble concentrating on things, such as reading the newspaper or watching television?*
Moving or speaking so slowly that other people could have noticed?
Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual?*
Thoughts that you would be better off dead, or of hurting yourself in some way?*