Depression Assessment (Adult)
Check the option that best describes how you have been feeling. How often have you been bothered by each of the following symptoms during the past two weeks?
Email *
First and Last Name  *
Please provide a phone number to call with your results *
Feeling down, depressed, irritable, or hopeless? *
Required
Little interest or pleasure in doing things? *
Required
Trouble falling asleep, staying asleep, or sleeping too much? *
Required
Poor appetite, weight loss, or overeating? *
Required
Feeling tired, or having little energy? *
Required
Feeling bad about yourself- or feeling that you are a failure, or that you have let yourself or your family down? *
Required
Trouble concentrating on things like reading the newspaper or watching TV? *
Required
Moving or speaking so slowly that other people have noticed? *
Required
Being so fidgety or restless that you were moving around a lot more than usual? *
Required
Thought you would be better off dead, or of hurting yourself in some way? *
Required
If you are experiencing any of the problems above, how difficult have these problems made it for you to do your work, take care of things around the house, or get along with other people? *
Required
A copy of your responses will be emailed to the address you provided.
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