Name:    Date of Birth:

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 from this list, how difficult have these made it for you to do your work, take care of things at home, or get along with other people?

Leave this empty:

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Document name: GAD-7
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April 20, 2020 10:35 am PDTGAD-7 Uploaded by Jason Dooley - IP
April 29, 2020 8:23 am PDTRecords Department - added by Jason Dooley - as a CC'd Recipient Ip:
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March 18, 2021 2:05 pm PDT Document owner has handed over this document to 2021-03-18 14:05:29 -
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