GAD-7 Anxiety

Name(Required)

First Last

Date of Birth(Required)

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

	Not at all (0 points)	Several days (1 point)	More than half the days (2 points)	Nearly every day (3 points)
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 is hard to sit still
6. Becoming easily annoyed or irritable
7. Feeling afraid, as if something awful might happen

Total Score - Please add up your points from the survey above and enter your total score here.(Required)

Please enter a number from 0 to 21.

If you checked any problems, 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