About this template
The PHQ-9 (Patient Health Questionnaire-9) and GAD-7 (Generalized Anxiety Disorder-7) form is an essential tool for mental health professionals, primary care physicians, therapists, and counselors. This validated screening combination allows clinicians to measure the severity of depression and anxiety symptoms in patients over a given timeframe.
By utilizing this standardized digital format, practices can streamline their intake process, allowing patients to complete their mental health assessments prior to appointments. The form gathers patient demographic details alongside symptom frequency matrices for both the PHQ-9 and GAD-7 frameworks, calculating or prompting for symptom scores to help guide clinical decision-making and ongoing care tracking.
Doc2Form makes it simple to deploy this clinical questionnaire as a clean Google Form, ensuring your practice can start collecting vital wellness data instantly while keeping workflows organized within your existing Google Workspace environment.
Key features
- Combined PHQ-9 and GAD-7 screening in a single digital questionnaire
- Standardized symptom frequency matrices for accurate scoring
- Pre-formatted for rapid deployment via Google Forms
- Streamlines remote patient intake and telehealth preparation
- Clear structure designed to reduce patient confusion and missing answers
Use cases
- Initial intake assessments for new therapy or counseling clients
- Routine mental health check-ins during ongoing psychiatric care
- Pre-appointment screening for telehealth and virtual care visits
- Primary care wellness checks and behavioral health integration
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Date of Assessment (Date)Select today's date.
- Little interest or pleasure in doing things (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Feeling down, depressed, or hopeless (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Trouble falling or staying asleep, or sleeping too much (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Feeling tired or having little energy (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Poor appetite or overeating (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Feeling bad about yourself — or that you are a failure or have let yourself or your family down (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Trouble concentrating on things, such as reading the newspaper or watching television (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Moving or speaking so slowly that other people could have noticed? Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Thoughts that you would be better off dead or of hurting yourself in some way (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Feeling nervous, anxious, or on edge (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Not being able to stop or control worrying (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Worrying too much about different things (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Trouble relaxing (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Being so restless that it is hard to sit still (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Becoming easily annoyed or irritable (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
- Feeling afraid as if something awful might happen (Multiple choice)Select the frequency that best applies to you over the past 2 weeks.
FAQ
What is the purpose of the PHQ-9 and GAD-7 scales?
The PHQ-9 is a standard screening tool for assessing depression severity, while the GAD-7 measures generalized anxiety severity. Together, they offer a comprehensive snapshot of a patient's emotional well-being.
Can I customize the questions on this Google Form?
Yes. Once you generate the template with Doc2Form, you have full ownership in Google Forms to add, remove, or modify any questions to fit your practice's specific needs.
Is this template suitable for telehealth appointments?
Absolutely. You can send the Google Form link to patients via email or secure messaging prior to their virtual visit, allowing them to complete the assessment from home.
How do I get started with this template?
Simply use Doc2Form to instantly convert and load this layout directly into your Google Forms account, and it will be ready to share with respondents.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.