Psychiatry Template
Anxiety Assessment GAD-7
A professional Psychiatry template for healthcare professionals.
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Subjective: Chief Complaint: Recurrent nightmares and increased daytime anxiety, ongoing for an unspecified duration. Patient Information: - Patient Name: Maria - Date of Birth (DOB): GAD-7 Anxiety Assessment Tool: (Assign scores based on the patient's response to how often they have been bothered by the following problems over the last 2 weeks: 0 = Not at all, 1 = Several days, 2 = More than half the days, 3 = Nearly every day.) 1. Feeling nervous, anxious, or on edge: 3 2. Not being able to stop or control worrying: 3 3. Worrying too much about different things: 3 4. Trouble relaxing: 3 5. Being so restless that it is hard to sit still: 2 6. Becoming easily annoyed or irritable: 2 7. Feeling afraid, as if something awful might happen: 3 Objective: Total GAD-7 Score: 19 Assessment: Anxiety Severity: (Use the scoring system below to determine severity based on the total score.) - 0–4: Minimal anxiety - 5–9: Mild anxiety - 10–14: Moderate anxiety - 15–21: Severe anxiety Anxiety Severity Level: Severe anxiety Impact on Daily Functioning: How difficult have the above problems made it for the patient to do their work, take care of things at home, or get along with other people? Very difficult
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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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