Generalized Anxiety Disorder 7-item (GAD-7) Scale
Today's Date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name
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First Name
Last Name
Date of Birth
*
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Over the last two weeks, how often have you been bothered by the following problems?
Rows
Not at all
Several Days
More than half the days
Nearly everyday
Feeling nervous, anxious or on edge
Not being able to stop or control worrying
Worry too much about different things
Trouble relaxing
Being so restless that it's hard to sit still
Becoming annoyed or irritable
Feeling afraid as if something awful might happen
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
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