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    GAD-7 Questionnaire

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

    (0) Not at all

    (1) Several Days

    (2) More than Half the Days

    (3) 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?

    Score:

    Name:

    Date of Birth:

    (one additional questionnaire is required – click next to continue)