Anxiety Assessment (GAD-7)
Name *
Your answer
Today's Date *
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DD
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YYYY
Email Address *
Your answer
Over the last 2 weeks how often have you been bothered by any of the following problems?
Feeling nervous, anxious or on edge *
Not being able to stop or control worrying *
Worrying too much about different things *
Trouble relaxing *
Being so restless that it is hard to sit still *
Becoming easily annoyed or irritable *
Feeling afraid as if something awful might happen *
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? *
Generalized Anxiety Disorder (GAD-7) Copyright© 1999 Pfizer Inc. All rights reserved.
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