|These questions are to ask you about things you may have felt most days in the past six months.||Yes||No|
|1. Most days I feel very nervous.|
|2. Most days I worry about lots of things.|
|3. Most days I cannot stop worrying.|
|4. Most days my worry is hard to control.|
|5. I feel restless, keyed up or on edge.|
|6. I get tired easily.|
|7. I have trouble concentrating.|
|8. I am annoyed or irritated.|
|9. My muscles are tense and tight.|
|10. I have trouble sleeping.|
|11. Did the things you noted above affect your daily life (home life, or work, or leisure) or cause you a lot of distress?|
|12. Were the things you noted above bad enough that you thought about getting help for them?|
Score of 0-5: Symptoms not suggestive of Generalized Anxiety Disorder.
Score of 6 or above: Symptoms suggestive of Generalized Anxiety Disorder. A complete evaluation is recommended.
Note: This questionnaire is provided for educational purposes only. It is not a substitute for consulting with a health professional. Even if an individual’s score on the questionnaire is “negative,” it is very important to consult with a primary care doctor or a mental health professional if there are concerns.
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