Phq 9 form pdf printable for teens 2026

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The document is a survey from a healthcare provider aimed at assessing mood and emotional concerns as part of routine health screening. It includes a series of questions regarding symptoms experienced over the past two weeks, such as feelings of depression, interest in activities, sleep issues, and thoughts of self-harm. The survey also inquires about the impact of these problems on daily functioning and includes questions about past experiences with depression and suicidal thoughts.

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Click ‘Get Form’ to open the PHQ-9 form in our editor.
Begin by entering your name, birthdate, doctor’s name, and today’s date at the top of the form.
For each symptom listed, mark an ‘X’ in the box that best describes how you have felt over the past two weeks. Options range from 'Not At All' to 'Nearly Every Day'.
Answer the questions regarding your feelings over the past year and any difficulties these problems may have caused in your daily life by selecting 'Yes' or 'No'.
Finally, indicate if you have ever had serious thoughts about ending your life or made a suicide attempt by checking 'Yes' or 'No'.

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Versions	Form popularity	Fillable & printable
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2010	4.3 Satisfied (28 Votes)

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Can you use PHQ-9 on teens?

The Patient Health Questionnaire Modified for Teens (PHQ-Modified) can be used with patients between the ages of 12 and 18. and takes less than five minutes to complete and score. The PHQ-9 Modified can be administered and scored by a nurse, medical technician, physical assistant, physician or other office.

Is the PHQ-9 free to use?

The PHQ-9 also has been used in many studies in primary care settings, as well as with older individuals and with those who have physically disabling conditions. It is free to users and available in English and over 30 other languages.

What is the Patient Health Questionnaire for adolescents PHQ A?

The Patient Health Questionnaire for Adolescents (PHQ-A) is a self-report questionnaire that is designed for the purpose of assessing anxiety, mood, eating, and substance use disorders among adolescent primary care patients.

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How do you score adolescent PHQ-9?

Scoring the PHQ-9 modified for Teens Need five or more positive symptoms (positive is defined by a \u201c2\u201d or \u201c3\u201d in questions 1-8 and by a \u201c1\u201d, \u201c2\u201d, or \u201c3\u201d in question 9).

Phq 9 form pdf printable for teens 2026

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