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Gad-7 Form

GAD-7 Anxiety

Name Date
Email Phone
Over the last two weeks, how often have you been bothered by the following problems? Not at all Several days More than half the days Nearly every day
1. Feeling nervous, anxious, or on edge0 1 2 3
2. Not being able to stop or control worrying0 1 2 3
3. Worrying too much about different things0 1 2 3
4. Trouble relaxing0 1 2 3
5. Being so restless that it is hard to sit still0 1 2 3
6. Becoming easily annoyed or irritable0 1 2 3
7. Feeling afraid, as if something awful might happen0 1 2 3
Column totals + + + =
Total Score

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

Source: Primary Care Evaluation of Mental Disorders Patient Health Questionnaire (PRIME-MD-PHQ). The PHQ was developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and colleagues.

Scoring GAD-7 Anxiety Severity

This is calculated by assigning scores of 0, 1, 2, and 3 to the response categories, respectively, of “not at all,” “several days,” “more than half the days,” and “nearly every day.” GAD-7 total score for the seven items ranges from 0 to 21.

  • 0–4: minimal anxiety
  • 5–9: mild anxiety
  • 10–14: moderate anxiety
  • 15–21: severe anxiety