PHQ-9 and GAD-7 FORMS - Transformative Growth

Transformative Growth Counseling

PHQ-9 & GAD-7

Please fill out the form below with either your full name or initials and date of birth. ONLY Clinical Staff or the Office Manager of Transformative Growth Counseling will be able to view this form.
Name *

First Name Last Name
Date of Birth *

Day Month Year
Date
Please choose your Therapist from the list below : *

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

Not at all

Several Days

More than half the days

Nearly every day

1. Little interest or pleasure in doing things

2. Feeling down, depressed or hopeless

3. Trouble falling or staying asleep, 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

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

Not at all

Several Days

More than half the days

Nearly every day

1. Feeling nervous, anxious, or on edge

2. Not being able to stop or control worrying

3. Worrying too much about different things

5. Being so restless that it is hard to sit still

6. Becoming easily annoyed or irritable

7. Feeling afraid as if something awful might happen

PHQ-9 Score (0-4 Minimal) (5-9 Mild) (10-14 Moderate) (15-19 Moderately-Severe) (20+ Severe)
GAD-7 Score (0-5 Minimal) (6-10 Mild) (11-15 Moderate) (16-21 Severe)
Should be Empty:

Merek Poto View Bio

Merek Poto is a compassionate and warm therapist who specializes in Gender and Identity Therapy.

Melodi Hickey View Bio

Melodi Hickey offers humanistic, person-centered therapy that focuses on incorporating mindfulness meditation.

Dalton Williams View Bio

Dalton Williams is a compassionate, warm counselor who aims to create a trusting and equal relationship with TGC Florida Clients throughout their therapeutic journey.

Kelly Rosensteel View Bio

Kelly is a Licensed Clinical Social Worker, who utilizes her expertise to create hands-on, real world solutions to life changes and transitions.

Julie Johnson View Bio

Julie Johnson is a Licensed Clinical Social Worker with a focus on individual goals and specific needs, creating a safe and supportive space for all her clients.

Renee Edwards View Bio

Renee Edwards is committed to helping her patients finding answers without judgement, specializing in working with veterans and other high-risk work-related issues.

Michael Alexander-Luz View Bio

Michael Alexander-Luz is our Director of Student Training, with specialized training in youth/adolescents, LGBTQ+, abuse/trauma history, and WPATH Standards.

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Copyright © 2021 Transformative Growth Counseling Florida . All Rights Reserved.

Talk to Us.

We are here for you and ready to help. Contact Our Office to set up an appointment.

Phone: (630)-423-6010

Email: contact@transformativegrowth.org

Or Click Here to:

Illinois:

Naperville

24W500 Maple Ave. Suite 216A

Naperville, IL

Kankakee

Inside Kankakee Community College

Olgesby, IL

Inside IVCC

Chicago:

Inside Phalanx

837 W 119th St

Chicago, IL 60643

FLORIDA

1724 Village Way.

Suite B

Orange Park, FL 32073

Mon – Fri:
Appointments Available (Mon – Sun):

08:00am – 05:00pm
07:00am – 10:00pm

Call or Text or go online* to Schedule an Appointment!

We are available to help! Contact us to set up an appointment, our Office Hours are 8am-5pm but we take calls 24/7.

Clinical Appointments are available 7am – 10pm every day.

** Self book online – click link below **

www.transformativegrowth.janeapp.com

Contact Info

Counseling Services

Individual Counseling
Couples Counseling
Family Counseling
LGBTQIA
Anxiety & Depression
Personality Issues
School, Family & Work Stress
Austim & ADHD
View All

Other Links

Call to Schedule Appointment!

Office Hours are 8am-5pm but we are available to take calls 24/7!

Clinical Appointments are available 7am – 10pm every day.

Office Info.

Additional Office Info.

Other Services

Individual Counseling
Couples Counseling
Family Counseling
LGBTQIA
Anxiety & Depression
Personality Issues
School, Family & Work Stress
Austim & ADHD
View All