PHQ-9 Depression Screening
Screening

PHQ-9 Depression Screening

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PHQ-9 Depression Screening
Patient Information
Little interest or pleasure in doing things
Feeling down, depressed, or hopeless
Trouble falling or staying asleep
Feeling tired or having little energy
Poor appetite or overeating
Feeling bad about yourself
Trouble concentrating
Moving or speaking slowly/being fidgety
Thoughts of self-harm
Difficulty these problems have caused
Select...
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The PHQ-9 Depression Screening form digitizes the Patient Health Questionnaire-9, the most widely used standardized instrument for screening and monitoring depression severity. The nine items assess the frequency of depressive symptoms over the past two weeks, scored on a 0-3 scale (not at all, several days, more than half the days, nearly every day).

The digital version automatically calculates the total score and provides severity interpretation: minimal (0-4), mild (5-9), moderate (10-14), moderately severe (15-19), and severe (20-27). This structured scoring eliminates manual calculation errors and provides instant clinical decision support, recommending appropriate clinical actions based on the score range.

The form includes the critical ninth question about self-harm and suicidal ideation, with conditional logic that flags positive responses for immediate clinical review. Additional context questions capture whether the patient is currently in treatment, taking antidepressant medication, and functional impairment level. This template is used in primary care annual screening, behavioral health intake, medication management follow-up, and clinical research. It meets USPSTF screening recommendations and CMS quality measure requirements.

What's included

  • All nine PHQ-9 validated screening items
  • Automatic score calculation and severity
  • Self-harm question with clinical flagging
  • Functional impairment assessment
  • Clinical action recommendations by score
  • Treatment status context questions

Who uses this template

  • Primary care annual depression screening
  • Behavioral health intake and follow-up
  • Medication management monitoring
  • Clinical research and quality measurement

All form fields

11 fields across 1 page. Customize any field after signing up.

Patient InformationText
Little interest or pleasure in doing thingsMultiple Choice
Feeling down, depressed, or hopelessMultiple Choice
Trouble falling or staying asleepMultiple Choice
Feeling tired or having little energyMultiple Choice
Poor appetite or overeatingMultiple Choice
Feeling bad about yourselfMultiple Choice
Trouble concentratingMultiple Choice
Moving or speaking slowly/being fidgetyMultiple Choice
Thoughts of self-harmMultiple Choice
Difficulty these problems have causedDropdown

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