therapy on the hill
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therapy on the hill
Client code
*
Please add your client code here
Date
MM
DD
YYYY
PHQ-9: Over the last 2 weeks, how often have you been bothered by any of the following problems?
*
a) Little interest or pleasure in doing things.
Not at all
Several days
More than half the days
Nearly every day
b) Feeling down, depressed or hopeless.
*
Not at all
Several days
More than half the days
Nearly every day
c) Trouble falling or staying asleep, or sleeping too much.
*
Not at all
Several days
More than half the days
Nearly every day
d) Feeling tired or having little energy.
*
Not at all
Several days
More than half the days
Nearly every day
e) Poor appetite or overeating.
*
Not at all
Several days
More than half the days
Nearly every day
f) Feeling bad about yourself – or that you are a failure or have let yourself or your family down.
*
Not at all
Several days
More than half the days
Nearly every day
g) Trouble concentrating on things, such as reading the newspaper or watching television.
*
Not at all
Several days
More than half the days
Nearly every day
h) 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
*
Not at all
Several days
More than half the days
Nearly every day
i) Thoughts that you would be better off dead or of hurting yourself in some way.
*
Not at all
Several days
More than half the days
Nearly every day
Thank you!