GAD-7 Anxiety Assessment
Created by
Michael Lee
Specialty
Psychiatrist
Last edited
10/20/2026
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0 times
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About this template
A structured template for documenting the GAD-7 anxiety questionnaire, including patient information, symptom-frequency scores over the previous two weeks, total score, anxiety severity, and the effect of symptoms on daily functioning.
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Patient Information
- Patient Name: Sarah Elizabeth Jenkins
- Date of Birth (DOB): 14/08/1989
GAD-7 Anxiety Assessment Tool
- Feeling nervous, anxious, or on edge: 3
- Being unable to stop or control worrying: 2
- Worrying excessively about various things: 2
- Having difficulty relaxing: 2
- Being so restless that remaining seated is difficult: 1
- Becoming easily annoyed or irritable: 2
- Feeling frightened, as though something terrible may happen: 1
Total GAD-7 Score: 13
Anxiety Severity
- 0–4: Minimal anxiety
- 5–9: Mild anxiety
- 10–14: Moderate anxiety
- 15–21: Severe anxiety
Anxiety Severity Level: Moderate anxiety
Impact on Daily Functioning
How difficult did the problems listed above make it for the patient to work, manage responsibilities at home, or relate to other people? Very difficult
How to use this template
This template can be used to assist with various tasks in the medical field. You can use it to generate notes, manage patient information, or assist with diagnosis and the Assessment and Plan. To use this template, simply click the “Use Template” button above. If you have any questions or need assistance, feel free to reach out to the support team or refer to the description and example output provided above.