Personal Growth Better Quality of Life Reduced Stress Generalized Anxiety Disorder Questionnaire (GAD-7) Date* MM slash DD slash YYYY Name* First Last DOB* MM slash DD slash YYYY How often in the past 2 weeks have you felt bothered by: HiddenHow often in the past 2 weeks have you felt bothered by: 1. Feeling nervous, anxious, or on edge?* 0 = not at all 1 = several days 2 = more than half the days 3 = nearly everyday 2. Not being able to stop or control worrying?* 0 = not at all 1 = several days 2 = more than half the days 3 = nearly everyday 3. Worrying too much about different things?* 0 = not at all 1 = several days 2 = more than half the days 3 = nearly everyday 4. Trouble relaxing?* 0 = not at all 1 = several days 2 = more than half the days 3 = nearly everyday 5. Being so restless that it is hard to sit still?* 0 = not at all 1 = several days 2 = more than half the days 3 = nearly everyday 6. Becoming easily annoyed or irritable?* 0 = not at all 1 = several days 2 = more than half the days 3 = nearly everyday 7. Feeling afraid as if something awful might happen?* 0 = not at all 1 = several days 2 = more than half the days 3 = nearly everyday If 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 all Somewhat difficult Very difficult Extremely difficult CommentsThis field is for validation purposes and should be left unchanged.
