Allied Health Solutions Medical Group
PHQ-9 and GAD-7
301 N Prairie Avenue, Suite 230
Inglewood, CA 90301
Tel: 323-944-0949, Text: 424-391-3739 Fax: 323-782-0388
Patient Information
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Over the past 14 days, how often have you been bothered by any of the following problems? Please select your answers.
PHQ-9
Not at all
Several days
More than half the days
Nearly every day
Required
Not at all
Several days
More than half the day
Nearly every day
Required
Not at all
Several days
More than half the days
Nearly every day
Required
Not at all
Several Days
More than half the days
Nearly
Required
Not at all
Several days
More than half the days
Nearly every day
Required
Not at all
Several days
More than half the days
Nearly
Required
Not at all
Several days
More than half the day
Nearly every day
Required
Not at all
Several days
More than half the day
Nearly every day
Required
Not at all
Several days
More than half the days
Nearly every day
Required
GAD-7
Not at all
Several days
Over half the days
Nearly every day
Required
Not at all
Several days
Over half the days
Nearly every day
Required
Not at all
Several days
Over half the days
Nearly every day
Required
Not at all
Several days
Over half the days
Nearly every day
Required
Not at all
Several days
Over half the days
Nearly every day
Required
Not at all
Several days
Over half the day
Nearly every day
Required
Not at all
Several days
Over half the day
Nearly every day
Required

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