Patient Health Questionnaire 9 (PHQ9)
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Name *
DOB *
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DD
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How often, over the past 2 weeks, have you been bothered by...
Little interest or pleasure in doing things? *
Feeling down, depressed or hopeless? *
Trouble falling or staying asleep, sleeping too much? *
Feeling tired or having little energy? *
Poor appetite or overeating? *
Feeling bad about yourself or that you are a failure or have let yourself or your family down? *
Trouble concentrating on things, such as reading the newspaper or watching television? *
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? *
Thoughts that you would be better off dead, or thoughts of hurting yourself in some way? *
How difficult have these problems made it to do work, take care of things at home, or get along with other people?
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