About this template
The PHQ-9 Rating Scale is a clinically validated tool used by mental health professionals, counselors, and physicians to screen for, diagnose, and measure the severity of depression. This standardized questionnaire evaluates symptoms experienced over the past two weeks, ranging from changes in sleep and appetite to persistent low mood and loss of interest.
Our free Google Form template simplifies the assessment process by digitizing the complete 9-item PHQ-9 inventory alongside essential patient details and dates of service. Practitioners can easily send this digital questionnaire to patients prior to an appointment or administer it securely during a session, streamlining documentation and clinical follow-ups.
Built on Google Forms through Doc2Form, this template allows for effortless distribution via direct link or email. Responses automatically populate in a secure spreadsheet, giving clinical teams structured data to track patient progress over time while reducing manual paperwork in busy mental health practices.
Key features
- Complete 9-item PHQ-9 depression screening questionnaire
- Includes patient identification and date of service tracking
- Standardized rating scale format for accurate score calculation
- Fully customizable to fit your clinic's specific intake workflow
- Instantly deploys as a ready-to-use Google Form
Use cases
- Initial psychological intake and diagnostic evaluations
- Routine mental health progress and symptom tracking
- Telehealth pre-session patient check-ins
- Clinical research and outcome measurement studies
What this form collects
- Patient Full Name (Short answer)Enter your first and last name.
- Date of Service (Date)Select today's date.
- Little interest or pleasure in doing things (Multiple choice)Over the last 2 weeks, how often have you been bothered by this?
- Feeling down, depressed, or hopeless (Multiple choice)Over the last 2 weeks, how often have you been bothered by this?
- Trouble falling or staying asleep, or sleeping too much (Multiple choice)Over the last 2 weeks, how often have you been bothered by this?
- Feeling tired or having little energy (Multiple choice)Over the last 2 weeks, how often have you been bothered by this?
- Poor appetite or overeating (Multiple choice)Over the last 2 weeks, how often have you been bothered by this?
- Feeling bad about yourself — or that you are a failure or have let yourself or your family down (Multiple choice)Over the last 2 weeks, how often have you been bothered by this?
- Trouble concentrating on things, such as reading the newspaper or watching television (Multiple choice)Over the last 2 weeks, how often have you been bothered by this?
- Moving or speaking so slowly that other people could have noticed, or being so fidgety or restless that you have been moving around a lot more than usual (Multiple choice)Over the last 2 weeks, how often have you been bothered by this?
- Thoughts that you would be better off dead or of hurting yourself in some way (Multiple choice)Over the last 2 weeks, how often have you been bothered by this?
- 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? (Dropdown)Select the option that best describes your level of difficulty.
FAQ
What is the PHQ-9 Rating Scale?
The PHQ-9 (Patient Health Questionnaire-9) is the standard multi-purpose instrument for screening, diagnosing, monitoring, and measuring the severity of depression.
How does this Google Form template work?
This template provides all standard PHQ-9 questions pre-formatted in Google Forms. You can instantly generate your own editable copy, customize it, and share it with patients.
Can patients complete this form on their mobile devices?
Yes, Google Forms are fully responsive and work seamlessly on smartphones, tablets, and desktop computers.
Where are the patient responses saved?
All submissions are automatically collected in a secure Google Sheets spreadsheet linked directly to your form for easy tracking and review.
Can I add custom clinic branding to the form?
Yes, you can easily add your practice logo, adjust theme colors, and include custom instructions or confidentiality notices.
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.