Patient Health Questionnaire (PHQ-9)

If you have been advised by the surgery to submit a Patient Health Questionnaire (PHQ-9) please use this form.

Patient Health Questionnaire (PHQ-9)

Patient Health Questionnaire (PHQ-9)

If you currently do not have a fixed address, please enter in the address field no fixed abode. If you are changing your address, please enter your old address in this section.

Review

Over the last 2 weeks, how often have you been bothered by any of the following problems:

Please answer the following questions using the following scale: 0 - never avoid it, 2- slightly avoid it, 4 - definitely avoid it, 6 - markedly avoid it, 8 - always avoid it