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Health Screening

Over the last 2 weeks, how often have you been bothered by any of the following problems?
         
 
Not At All
Sereval Days
More than half the Days
Nearly Every Day
Little Interest or Pleasure in doing things




         
Feeling down, depressed or hopeless




         
Trouble Falling or staying asleep or sleeping too much




         
Feeling Tired or having little energy




         

Poor appetite or overeating




         
Feeling bad about yourself or that you are a failure or have let yourself or your family down




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




         
Moving or speaking so slowly that other people could have noticed. Or the opposite - being so figety or restless that you have been moving around a lot more than usual.




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




         
 
Not difficult at all
Somewhat difficult
Very difficult
Extremely difficult
If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?




         
         
         
         
         


 
 
 
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