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Generalised Anxiety Disorder Questionnaire (GAD-7)
GAD-7
Name
(Required)
First
Last
Date of birth
(Required)
Day
Month
Year
Email
(Required)
Phone
(Required)
Todays date
(Required)
Day
Month
Year
Name of course
(Required)
CHIMO Trust 001
Generalised Anxiety Disorder Questionnaire (GAD-7)
Over the last two weeks, how often have you been bothered by any of the following problems?
Feeling nervous, anxious or on edge?
(Required)
Not at all
Several days
More than half the days
Nearly every day
Not being able to stop or control worrying?
(Required)
Not at all
Several days
More than half the days
Nearly every day
Worrying too much about different things?
(Required)
Not at all
Several days
More than half the days
Nearly every day
Trouble relaxing?
(Required)
Not at all
Several days
More than half the days
Nearly every day
Being so restless that it is hard to sit still?
(Required)
Not at all
Several days
More than half the days
Nearly every day
Becoming easily annoyed or irritable?
(Required)
Not at all
Several days
More than half the days
Nearly every day
Feeling afraid as if something awful might happen?
(Required)
Not at all
Several days
More than half the days
Nearly every day
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