PHQ-9 Name PHQ-9 Please complete the following if you have been asked to do so. First Name * Client ID (if known) Last Name * Email Address * Over the last 2 weeks, how often have you been bothered by the following problems. For each of the following please choose the option that fits best. 0=Not at all 1=Several days =More than half the days 3=Nearly every day Little interest or pleasure in doing things * 0 1 2 3 Feeling down, depressed, or hopeless * 0 1 2 3 Trouble falling or staying asleep, or sleeping too much * 0 1 2 3 Feeling tired or having little energy * 0 1 2 3 Poor appetite or overeating 0 1 2 3 Feeling bad about yourself — or that you are a failure or have let yourself or your family down * 0 1 2 3 Trouble concentrating on things, such as reading the newspaper or watching television * 0 1 2 3 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 * 0 1 2 3 Thoughts that you would be better off dead or of hurting yourself in some way * 0 1 2 3
