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GAD / PHQ Assessment
ARCUS
2026-02-18T13:52:42+00:00
GAD 7 & PHQ 9 Assessment
Client Name
*
Assessors Name
*
Date
*
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GAD 7 Assessment (Generalised Anxiety Disorder Assessment)
In the last two weeks [14 days], how often has the client been bothered by the following items. Score each item [PUT SCORE IN THE BOX] as: 0 = not at all, 1= several days, 2 = more than half of the days, 3 = almost every day
Feeling nervous anxious or on edge?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Not being able to stop or control worrying?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Worrying too much about different things?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Trouble relaxing?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Being so restless that it is hard to sit still?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Becoming easily annoyed or irritable?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Feeling afraid as if something awful might happen?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Total Scores for GAD 7 Assessment
Scores from the GAD 7 assessment represent:
*
Select
0-5 mild
6-10 moderate
11-15 moderately severe anxiety
15-21 severe anxiety
PHQ 9 Assessment (Patient health questionaire)
In the last two weeks [14 days], how often has the client been bothered by the following items. Score each item [PUT SCORE IN THE BOX] as: 0=not at all 1= several days, 2 = more than half of the days, 3=almost every day
Little interest or pleasure in doing things?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Feeling down, depressed, or hopeless?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Trouble falling or staying asleep, or sleeping too much?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Feeling tired or having little energy?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Poor appetite or overeating?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Feeling bad about yourself, or that you are a failure or have let yourself or your family down?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Trouble concentrating on things, such as reading the newspaper or watching television?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Moving or speaking so slowly that other people could have noticed? Or the opposite being really fidgety or restless?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Thoughts that you would be better off dead or of hurting yourself in some way?
*
Select
0 - Not at all
1 - Several days
2 - More than half the days
3 - Almost every day
Total Scores for PHQ 9 Assessment
Scores from the PHQ 9 assessment represent:
*
Select
0-4 none
5 - 9 Mild
10-14 moderate
15-19 moderately severe
20-27 severe
Email Address
*
If you would like a copy of this for future sessions please enter your work email here
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