Patient Health Questionnaire – General Anxiety Disorder
(PHQ-9 and GAD07)

Patient Health Questionnaire - General Anxiety Disorder

"*" indicates required fields

Step 1 of 2

Patient Name*

PHQ-9

Over the last two weeks, how often have you been bothered by any of the following problems?
1. Little interest or pleasure in doing things*
2. Feeling down, depressed, or hopeless.*
3. Trouble falling or staying asleep, or sleeping too much.*
4. Feeling tired or having little energy.*
5. Poor appetite or overeating.*
6. Feeling bad about yourself – or that you are a failure or have let yourself or your family down.*
7. Trouble concentrating on things, such as reading the newspaper or watching television.*
8. 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.*
9. Thoughts that you would be better off dead, or hurting yourself in some way.*
(add your totals from the questions above)
If you checked off any problems, how difficult have these made it for your to do your work, take care of things at hoem, or get along with people?*

UHS Rev 4/2020
Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission required to reproduce, translate, display or distribute, 1999.