Personal Growth Better Quality of Life Reduced Stress Generalized Anxiety Disorder Questionnaire (GAD-7) Date* Date Format: MM slash DD slash YYYY Name* First Last DOB* Date Format: MM slash DD slash YYYY How often in the past 2 weeks have you felt bothered by: How often in the past 2 weeks have you felt bothered by: 1. Feeling nervous, anxious, or on edge?*0 = not at all1 = several days2 = more than half the days3 = nearly everyday2. Not being able to stop or control worrying?*0 = not at all1 = several days2 = more than half the days3 = nearly everyday3. Worrying too much about different things?*0 = not at all1 = several days2 = more than half the days3 = nearly everyday4. Trouble relaxing?*0 = not at all1 = several days2 = more than half the days3 = nearly everyday5. Being so restless that it is hard to sit still?*0 = not at all1 = several days2 = more than half the days3 = nearly everyday6. Becoming easily annoyed or irritable?*0 = not at all1 = several days2 = more than half the days3 = nearly everyday7. Feeling afraid as if something awful might happen?*0 = not at all1 = several days2 = more than half the days3 = nearly everydayIf you checked off 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 allSomewhat difficultVery difficultExtremely difficultPhoneThis field is for validation purposes and should be left unchanged.
