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Run: GAD-7 Anxiety Screening and Scoring Form

Use this GAD-7 Anxiety Screening and Scoring Form to capture the 7 symptom responses, calculate the total score, and document severity at intake or follow-up...

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Screening Context

Screening date (required)

Screening type (required)

Symptom timeframe (required)

If other, specify timeframe

Patient identifier

Use your organization's internal identifier only. Do not collect SSN or other unnecessary PII.

GAD-7 Symptom Questions

Feeling nervous, anxious, or on edge (required)

Not being able to stop or control worrying (required)

Worrying too much about different things (required)

Trouble relaxing (required)

Being so restless that it is hard to sit still (required)

Becoming easily annoyed or irritable (required)

Feeling afraid as if something awful might happen (required)

Scoring and Severity

GAD-7 total score

Severity level

Symptom change since last screening

Follow-Up Notes and Next Steps

Clinical notes

Follow-up needed

Yes No N/A

Consent and disclosure acknowledgement (required)

I understand this screening collects limited health information for clinical assessment and care coordination, and it will be handled according to applicable privacy and consent requirements.

Yes No N/A

Get your results

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Email (required)

Your name (optional)

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