HMB PHQ9 GAD7
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PHQ-9: Depression Screening 

 

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


Question

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

1. Little interest or pleasure in doing things





2. Feeling down, depressed, or hopeless





3. Trouble falling/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





8. Moving/speaking slowly OR being fidgety/restless





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






PHQ-9 Total Score: __________


GAD-7: Anxiety Screening


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


Question

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

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’s hard to sit still





6. Becoming easily annoyed or irritable





7. Feeling afraid as if something awful might happen







GAD-7 Total Score: __________

 

1
PDF page break

PHQ-9: Depression Screening 

 

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


Question

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

1. Little interest or pleasure in doing things





2. Feeling down, depressed, or hopeless





3. Trouble falling/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





8. Moving/speaking slowly OR being fidgety/restless





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






PHQ-9 Total Score: __________


GAD-7: Anxiety Screening


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


Question

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

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’s hard to sit still





6. Becoming easily annoyed or irritable





7. Feeling afraid as if something awful might happen







GAD-7 Total Score: __________