Over the last 2 WEEKS how often you have been bothered by any of the following problems? 

Patient Health Questionnaire (PHQ 9)

Example

1. Feeling down, depressed, or hopeless

2. Little interest or pleasure in doing things

3. Trouble falling asleep or staying asleep, sleeping too much

4. Feeling tired or having low energy

5. Poor appetite or overeating

6. Feeling bad about yourself, or that you are a failure or you have let 

yourself or your family down

Select an option
Select an option
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7. Trouble concentrating on things, such reading newspaper or watching TV

Select an option

8. Moving or speaking so slow 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

Select an option

9. Thoughts that you would be better off dead or of hurting yourself

Select an option

Generalized Anxiety Disorder (GAD7)

Over the last 2 WEEKS how often you have been bothered by any of the following problems? 

Example

1. Feeling nervous, anxious, or on edge

Select an option

2. Not being able to stop or control worrying

Select an option

3. Worrying too much about different things

Select an option

4. Trouble relaxing

Select an option

5. Being so restless thats its hard to sit still

Select an option

6. Becoming easily annoyed or irritable

Select an option

7. Feeling afraid as if something awful might happen

Select an option