Patient Health Questionnaire (PHQ-9)

The PHQ-9 is a simple yet valuable tool that helps us assess where you might be in terms of your mood and overall mental health. It's designed to identify the signs of depression by asking you about your experience with certain feelings and behaviors that align with the diagnostic criteria for depression.

As you go through the questions, you'll be asked to rank how often you've felt or experienced certain symptoms. This helps us gauge not only if you're experiencing depression, but also how severe it might be.

This process is all about helping us find the right support for you, so answer as honestly as you can—there's no right or wrong here.

Full Name *

Date of birth *

Email *

Phone *

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to (984) 212-3788 or +1 866-719-9996 for assistance. You can reply STOP to unsubscribe at any time.

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

1. Little interest or pleasure in doing things *

2. Feeling down, depressed, or hopeless *

3. Trouble falling or staying asleep, or sleeping too much *

4. Feeling tired or having little energy *

5. Poor appetite or overeating *

6. Feeling bad about yourself - or that you are a failure or have let yourself or your family down *

7. Trouble concentrating on things, such as reading the newspaper or watching television *

8. 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 *

9. Thoughts that you would be better off dead, or of hurting yourself *

If you checked any problems, how difficult have they made it for you to do your work, take care of things at home, or get along with other people? *

Not difficult at all

Somewhat difficult

Very difficult

Extremely difficult

Please make sure you click SUBMIT to finalize your responses.

Thank you for responding!

We will get back to you soon!