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The Peninsula Practice

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Join Our Practice
Appointments
Practice Information
Services We Provide
Prescriptions
Compassionate Companions
Your Local Resource Hub
Patient Participation Group
Condition-specific guidance
Your Information - Patient Record

Home
Home
Contact Us Online
New Patients
Prescriptions, Appointments & Your Record
Contact Details
Opening Hours
Our Staff

Home
Anxiety Disorder Assessment (GAD-7)

Anxiety Disorder Assessment (GAD-7)

Anxiety Disorder Assessment (GAD-7)

Your Details

Name *

Date of Birth *

Phone Number

Email Address *

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

Feeling nervous, anxious or on edge? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

Not being able to stop or control worrying? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

Worrying too much about different things? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

Trouble relaxing? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

Being so restless that it is hard to sit still? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

Becoming easily annoyed or irritable? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

Feeling afraid as if something awful might happen? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

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Page last reviewed: 15 August 2023
Page created: 26 May 2020

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