GAD-7 (Anxiety Assessment Tool) Generalized Anxiety Disorder 7-item (GAD-7) scale * Input number based on your choices: Not at all - 0, Several days - 1, More than half the days - 2, Nearly every day - 3 First Name Last Name Phone (###) ### #### Email * What triggers your anxiety? * 1. Feeling nervous, anxious, or on edge 0 1 2 3 2. Feeling nervous, anxious, or on edge 0 1 2 3 3. Worrying too much about different things 0 1 2 3 4. Trouble relaxing 0 1 2 3 5. Being so restless that it is hard to sit still 0 1 2 3 6. Becoming easily annoyed or irritable 0 1 2 3 7. Feeling afraid, as if something awful might happen 0 1 2 3 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 Thank you!
