SELF-TEST FOR ANXIETY Self-Test for Anxiety Form (ID #77)Please enable JavaScript in your browser to complete this form. - Step 1 of 2Name *FirstLastPhone *Email *NextComplete all questions to submit your testThis questionnaire called the GAD-7 screening tool can help you find out if you might have an anxiety disorder that needs treatment. It calculates how many common symptoms you have and based on your answers suggests where you might be on a scale, from mild to severe anxiety. - GAD-7 stands for "generalized anxiety disorder" and the 7 questions in the tool. Choose one answer for each of the 7 questions below: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 day2) Not being able to stop or control worrying *(0) Not at all(1) Several days(2) More than half the days(3) Nearly every day3) Worrying too much about different things *(0) Not at all(1) Several days(2) More than half the days(3) Nearly every day4) Trouble relaxing *(0) Not at all(1) Several days(2) More than half the days(3) Nearly every day5) Being so restless that it's hard to sit still *(0) Not at all(1) Several days(2) More than half the days(3) Nearly every day6) Becoming easily annoyed or irritable *(0) Not at all(1) Several days(2) More than half the days(3) Nearly every day7) Feeling afraid, as if something awful might happen *(0) Not at all(1) Several days(2) More than half the days(3) Nearly every dayTotal Score *= 0.00What your total score meansYour total score is a guide to how severe your anxiety disorder may be: - • 0 to 4 = mild anxiety • 5 to 9 = moderate anxiety • 10 to 14 = moderately severe anxiety • 15 to 21 = severe anxietySignature *Clear SignatureSubmit
