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Hermitage Medical Practice

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Appointments
Prescriptions
Join the Practice
Send an Image
Practice Forms
Request a Sick Note
Our Services
Community Resources
Contact Us

Home
Language
Appointments
Prescriptions
Join the Practice
Our Services
About Us
Community Resources

Patient Notice:

****From early 2025 - New practice location for Hermitage Medical Practice**** Hermitage Medical Practice will be moving from Hermitage Terrace to the Balfour Pavilion at the Astley Ainsle

Find out more

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Anxiety Disorder Assessment (GAD-7)

Last Updated: 08/02/2023

Your Details

Name *

Date of Birth *

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

Feeling nervous, anxious or on edge? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

Not being able to stop or control worrying? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

Worrying too much about different things? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

Trouble relaxing? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

Being so restless that it is hard to sit still? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

Becoming easily annoyed or irritable? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

Feeling afraid as if something awful might happen? *

Not at all (0)

Several days (1)

More than half the days (2)

Nearly every day (3)

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