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PHQ-9 Depression Assessment Form

Fill out and submit the form below with the correct information.

Name(Required)

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

0 - Not at all
1 - Several days
2 - More than half the days
3 - Nearly every day
1. LITTLE INTEREST OR PLEASURE IN DOING THINGS
2. FEELING DOWN, DEPRESSED, OR HOPELESS
3. TROUBLE FALLING OR STAYING ASLEEP TOO MUCH
4. FEELING TIRED OR HAVING LITTLE ENERGY
5. POOR APPETITE OR OVER EATING
6. FEEL BAD ABOPUT YOUR SELF - OR THAT YOU ARE A FAILURE OR HAVE LET YOURSELF OR FAMILY DOWN
7. TROUBLE CONCENTRATING ON THINGS, SUCH AS READING THE NEWSPAPER OR WATCHING TELEVISION
8. MOVING OR SPEAKING SO SLOWLY THAT OPTHER PEOPLE COULD HAVE NOTICE . OR THE OPPOSITE - BEING SO FIDGETY OR RESTLESS THAT YOU HAVE BEEN MOVING AROUND A LOT MORE THAN USUAL
9. THOUGHTS THAT YOU HAVE BEEN BETTER OFF DEAD , OR HURTING YOURSELF IN SOME WAY
9. THOUGHTS THAT YOU HAVE BEEN BETTER OFF DEAD , OR HURTING YOURSELF IN SOME WAY

Iconic Health Services offers in-person and online services for prescriptions, medication, telepsychiatry, and combined psychotherapy to residents of New Jersey.

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