Generalised Anxiety Disorder Assessment (GAD 7)

Complete this form if you have been asked to fill out a Generalised Anxiety Disorder assessment (GAD 7)

You can also use accuRx to submit an online assessment.

Your Details

Title

First Names

Surname

Date of Birth

Home Address

Postcode

Best telephone number to contact you

Assessment Questions

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

Feeling nervous, anxious or on edge

Not being able to stop or control worrying

Worrying too much about different things

Trouble relaxing

Being so restless that it is hard to sit still

Becoming easily annoyed or irritable

Feeling afraid as if something awful might happen

If you checked off any problems, how difficult have these made it for you to do your work, take care of things at home, or get along with other people?

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