GAD 7 Questionnaire
Over the last 2 weeks, how often have you been bothered about the following subjects (0-Not at all, 1-several days, 2-Over half the days, 3-Nearly Every day)
Name
*
First Name
Last Name
Overall satisfaction
(0) Not at all
(1) Several Days
(2) Over half the days
(3) Nearly Every Day
1.Family, or any family related events/issues
Financial situations or anything financially related
Significant other, or relationships
Anything related to your health
Events that happened in your past
Organization
Events that are approaching (Future)
Living Situations
If you checked any problems, how difficult have they 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
0–4: minimal anxiety 5–9: mild anxiety 10–14: moderate anxiety 15–21: severe anxiety
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