Nancy Nguyen, LCSW

Expanding Pathways · San Jose, California

GAD-7 · anxiety screening

Seven questions about the last two weeks. It takes about two minutes. Answer for how things have actually been, not how you think they should be. We may repeat this periodically alongside the PHQ-9.

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

1.Feeling nervous, anxious, or on edge

Not at allSeveral daysMore than half the daysNearly every day

2.Not being able to stop or control worrying

Not at allSeveral daysMore than half the daysNearly every day

3.Worrying too much about different things

Not at allSeveral daysMore than half the daysNearly every day

4.Trouble relaxing

Not at allSeveral daysMore than half the daysNearly every day

5.Being so restless that it is hard to sit still

Not at allSeveral daysMore than half the daysNearly every day

6.Becoming easily annoyed or irritable

Not at allSeveral daysMore than half the daysNearly every day

7.Feeling afraid, as if something awful might happen

Not at allSeveral daysMore than half the daysNearly every day

Total score 0 / 21 Not yet complete

This score is a starting point for conversation, not a diagnosis.

Impact

If you checked off any problems, how difficult have they made it for you to do your work, take care of things at home, or get along with other people?

Not difficult at allSomewhat difficultVery difficultExtremely difficult

Printed name

Date

Your completed form has downloaded. Please bring the PDF to your appointment, or send it back to Nancy Nguyen, LCSW.

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. Scoring is performed in your browser; nothing is transmitted or stored online.