Anxiety Screening Tool

This is generalized anxiety screen may be used to assess the likelihood of someone suffering from symptoms of generalized anxiety. Please answer all questions as honestly and openly as possible. If you are taking this on behalf of a loved one, please note that all of these questions will be phrased as if that person were taking this screening. If suggested, contact us as soon as you can.

Please note, this screening does not serve as a diagnosis tool but can aid your clinician in determining our recommended course of action.

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 all1. Several Days2. More than half the days3. Nearly every day

2. Not being able to stop or control worrying *0. Not at all1. Several Days2. More than half the days3. Nearly every day

3. Worrying too much about different things *0. Not at all1. Several Days2. More than half the days3. Nearly every day

4. Trouble relaxing *0. Not at all1. Several Days2. More than half the days3. Nearly every day

5. Being so restless that it is hard to sit still *0. Not at all1. Several Days2. More than half the days3. Nearly every day

6. Becoming easily annoyed or irritated *0. Not at all1. Several Days2. More than half the days3. Nearly every day

7. Feeling afraid as if something awful might happen *0. Not at all1. Several Days2. More than half the days3. Nearly every day

8. If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? *Not difficult at allSomewhat difficultVery difficultExtremely difficult

When did the symptoms begin? *

Your Score

0 - 2 > None/Minimal

ACTION – None

Your Score

8 or Higher > Moderate/Severe Treatment

Action – Please schedule a consultation with Dr. Cruz or your physician.

First Name *

Last Name *

Your Email *

Select Your State *

Electronic Communication Consent

Providing us with authorization to email and text you will allow Kentuckiana Integrative Medicine - Kentuckiana Medicine to exchange information with you more efficiently and will benefit you as a member patient. We have made considerable effort to protect the personal health information of our member patients. The messages we will send are focused on promoting good health and education.

Yes, you can communicate with me via email. Subscribe me to the newsletter.

Yes, you can communicate with me via text message.

Security Question (10-5=?) *

GAD-2 Score

GAD-7 Score

SCORE

0 – 2 > None-minimal

ACTION – None

8 or Higher > Moderate/Severe Treatment Recommended

ACTION – Please schedule a consultation with Dr. Cruz or your physician.

This instrument is designed for screening purposes only and is not to be used as a diagnostic tool.

Sources

Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized
anxiety disorder: the GAD-7. Archives of internal medicine. May 22 2006;166(10):1092-
1097. PMID: 16717171

Kroenke K, Spitzer RL, Williams JB, Monahan PO, Lowe B. Anxiety disorders in primary
care: prevalence, impairment, comorbidity, and detection. Annals of internal medicine.
Mar 6 2007;146(5):317-325. PMID: 17339617

Lowe B, Decker O, Muller S, et al. Validation and standardization of the Generalized
Anxiety Disorder Screener (GAD-7) in the general population. Medical care. Mar
2008;46(3):266-274. PMID: 18388841

Back To Top

Follow us on Facebook for Weekly Medical Insights

About Us

405 E Court Ave #102, Jeffersonville, IN 47130

(812) 913-4416

Links

Conditions
How We Treat
Assessment Forms
FAQ
Testimonials
Contact Us
Careers

Latest Posts

Why Choose Kentuckiana Integrative Medicine-Kentuckiana Ketamine Institute?
Teen Suicide Prevention
Can You Recognize the Signs of Depression?
Mental Health Challenges, Pain, and Ketamine

Disclaimer

This article is strictly informational. We make no implied or explicit claims of treatment effectiveness or suitability. Those decisions are between you and your physician.
Like all medical procedures, our procedures have a success and failure rate. Patient testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments.

Medical Disclaimer
Terms and Conditions
Privacy Policy
Accessibility Statement