Family Medicine Template
Anxiety Assessment GAD-7
A professional Family Medicine template for healthcare professionals.
Preview template
Subjective: Chief Complaint: Follow-up for diabetes and hypertension management Patient Information: - Patient Name: Jordan - Date of Birth (DOB): GAD-7 Anxiety Assessment Tool: 1. Feeling nervous, anxious, or on edge: 0 2. Not being able to stop or control worrying: 0 3. Worrying too much about different things: 0 4. Trouble relaxing: 0 5. Being so restless that it is hard to sit still: 0 6. Becoming easily annoyed or irritable: 0 7. Feeling afraid, as if something awful might happen: 0 Objective: Total GAD-7 Score: 0 Assessment: Anxiety Severity: - 0–4: Minimal anxiety Anxiety Severity Level: Minimal anxiety Impact on Daily Functioning: Not difficult at all
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How to use this template
This comprehensive new patient template helps establish care by capturing complete medical history, current concerns, and baseline health status. Use this for patients during their initial visit to create a thorough medical record.
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