Generalized Anxiety Disorder Screener (GAD-7)

Generalized Anxiety Disorder Screener (GAD-7)
Client Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Facility Name (if applicable)
Stage of Treatment*

New ClientDuring TreatmentEnd of Treatment
Over the last 2 weeks, how often have you been bothered by the following problems?
1. Feeling nervous, anxious or on edge

[0] Not at all[1] Several Days[2] More than half the days[3] Nearly every day
2. Not being able to stop or control worrying

[0] Not at all[1] Several Days[2] More than half the days[3] Nearly every day
3. Worrying too much about different things

[0] Not at all[1] Several Days[2] More than half the days[3] Nearly every day
4. Trouble relaxing

[0] Not at all[1] Several Days[2] More than half the days[3] Nearly every day
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 every day
6. Becoming easily annoyed or irritated

[0] Not at all[1] Several Days[2] More than half the days[3] Nearly every day
7. Feeling afraid as if something awful might happen

[0] Not at all[1] Several Days[2] More than half the days[3] Nearly every day
8. 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?

[0] Not difficult at all[1] Somewhat difficult[2] Very difficult[3] Extremely difficult
Calculation
When did symptoms begin?
When did symptoms begin?

MonthDayYear
Date

Generalized Anxiety Disorder Screener (GAD-7)
Scoring and Interpretation:

GAD-2-Score	Provisional Diagnosis
0-2	None
3-6	Probable anxiety disorder
GAD-7-Score	Provisional Diagnosis
0-7	None
8+	Probable anxiety disorder

References:
• Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of internal medicine. May 22 2006;166(10):1092- 1097. PMID: 16717171
• Kroenke K, Spitzer RL, Williams JB, Monahan PO, Lowe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Annals of internal medicine. Mar 6 2007;146(5):317-325. PMID: 17339617
• Lowe B, Decker O, Muller S, et al. Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Medical care. Mar 2008;46(3):266-274. PMID: 18388841

Should be Empty:

Generalized Anxiety Disorder Screener (GAD-7)

Over the last 2 weeks, how often have you been bothered by the following problems?