GAD-7 Today's Date* MM slash DD slash YYYY Client's Name* First Last Client's Date of Birth*MMMM123456789101112DDDD12345678910111213141516171819202122232425262728293031YYYYYYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920This field is hidden when viewing the formEmail Enter Email Confirm Email GAD-7Over the last 2 weeks, how often have you been bothered by the following problems?1. Feeling nervous, anxious, or on edge:* Not at all Several days Over half the days Nearly every day 2. Not being able to stop or control worrying:* Not at all Several days Over half the days Nearly every day 3. Worrying too much about different things:* Not at all Several days Over half the days Nearly every day 4. Trouble relaxing:* Not at all Several days Over half the days Nearly every day 5. Being so restless that it's hard to sit still:* Not at all Several days Over half the days Nearly every day 6. Becoming easily annoyed or irritable:* Not at all Several days Over half the days Nearly every day 7. Feeling afraid as if something awful might happen:* Not at all Several days Over half the days Nearly every day This field is hidden when viewing the formTotalIf you checked off any problems, how difficult have these 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
