< Browse the Survey Templates + Write another survey

PHQ9

Preview the Survey
+ Add to Projects
Show/Hide Guidance
X - Close

Makerble® Strategies

Discover insights you never had time to find

Interval Icon Interval Versions
Master Survey

Master Survey

Collect Responses

Collect Responses

Response Rates

Response Rates

Analyse Results

Analyse Results

Series Analysis

Series Analysis

About

Uploaded by: Curated by Makerble

The PHQ-9 easy to use survey is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. This is the depression module, which scores each of the nine DSM-IV criteria as "0" (not at all) to "3" (nearly every day).

*Q1. Date the activity actually happened

Q2. Having little interest or pleasure in doing things (single choice)

Question Settings ▼ ▲

Over the last two weeks, how often have you been bothered by having Little interest or pleasure in doing things

as a manager at clearview, how do you see your interest in doing things

How do you feel your manager is at xyz

Not at all Several days More than half the days Nearly every day
0 1 2 3

Dropdown List used: Little interest or pleasure in doing things

Q3. Feeling down, depressed, or hopeless (single choice)

Question Settings ▼ ▲

Over the last two weeks, how often have you been bothered by feeling down, depressed, or hopeless

Hide this question

Not at all Several days More than half the days Nearly every day
0 1 2 3

Dropdown List used: Little interest or pleasure in doing things

Q4. Trouble falling or staying asleep, or sleeping too much (single choice)

Question Settings ▼ ▲

Over the last two weeks, how often have you been bothered by trouble falling or staying asleep, or sleeping too much

Not at all Several days More than half the days Nearly every day
0 1 2 3

Dropdown List used: Little interest or pleasure in doing things

Q5. Feeling tired or having little energy (single choice)

Question Settings ▼ ▲

Over the last two weeks, how often have you been bothered by feeling tired or having little energy

Not at all Several days More than half the days Nearly every day
0 1 2 3

Dropdown List used: Little interest or pleasure in doing things

Q6. Poor appetite or over eating (single choice)

Question Settings ▼ ▲

Over the last two weeks, how often have you been bothered by poor appetite or over eating

Not at all Several days More than half the days Nearly every day
0 1 2 3

Dropdown List used: Little interest or pleasure in doing things

Q7. Feeling bad about yourself - or that you are a failure or have let you or your family down (single choice)

Question Settings ▼ ▲

Over the last two weeks, how often have you been bothered by feeling bad about yourself - or that you are a failure or have let you or your family down

Not at all Several days More than half the days Nearly every day
0 1 2 3

Dropdown List used: Little interest or pleasure in doing things

Q8. Trouble concentrating on things, such as reading newspaper or watching television (single choice)

Question Settings ▼ ▲

Over the last two weeks, how often have you been bothered by trouble concentrating on things, such as reading newspaper or watching television

Not at all Several days More than half the days Nearly every day
0 1 2 3

Dropdown List used: Little interest or pleasure in doing things

Q9. Noticeably moving or speaking slowly, or being fidgety or restless (single choice)

Question Settings ▼ ▲

Over the last two weeks, how often have you been bothered by moving or speaking so slowly that other people could have noticed, or the opposite – being so fidgety or restless that you have been moving

Not at all Several days More than half the days Nearly every day
0 1 2 3

Dropdown List used: Little interest or pleasure in doing things

Q10. Thinking you'd be better off dead, or hurting yourself in some way (single choice)

Question Settings ▼ ▲

Over the last two weeks, how often have you been bothered by thoughts that you would be better off dead, or hurting yourself in some way

Not at all Several days More than half the days Nearly every day
0 1 2 3

Dropdown List used: Little interest or pleasure in doing things

Collect survey responses

360°
360°
Invite observers to answer a survey about a contact in your CRM. Send out invitations for several contacts at once via email, SMS or your own channels.

Collect Responses

Universal
Universal
Allow anyone with the link to submit a survey response.
Optionally generate a QR code.
Share Link

Tracked
Tracked
Track responses to individual contacts. Send survey invitations via email and SMS - with automated reminders - or your own communication channels.
Collect Responses

Anonymised
Anonymised
Hide the identity of each respondent when collecting responses from saved contacts or a list of email addresses.
Collect Responses

Import
Import
Upload survey responses from a spreadsheet with a row per respondent and column per question.
Import Responses

API
API
Send out survey invitations programmatically and/or receive responses via the API..
Get Started

Type Up: 1 at a time
Type Up: 1 at a time
Submit a survey response about a saved contact while filling in a survey in-person (CAPI), over the phone (CATI) or typing up a paper survey response.
Collect Response

Type Up: Several at once
Type Up: Several at once
Use the Answers Table to submit responses to each question. There’s one row per contact. Responses are automatically linked to individual contacts.
Enter Responses

Type Up: Manual Headcount
Type Up: Manual Headcount
Enter responses without the need for individual contacts or respondents. Enter the number of people who gave each answer to each question.
Enter Quantities

Universal Manual Headcount
Universal Manual Headcount
Collect manual headcount responses from anyone with the link.

Share Link

Multi-stage
Multi-stage
Collect demographic data. Thread several surveys together. Deliver advanced survey experiences.
Go to Signup Pages

Branded Portal
Branded Portal
Provide respondents with a password-protected space to submit, review, discuss or act upon survey responses.
Get Started

Automation
Automation
Automatically send out survey invitations whenever certain rules are met
Create an automation

X
Close

Adjust When

Step 1: Where will this adjustment be applied?

Step 2: When will this adjustment be applied?

Step 3: Who does this adjustment apply to?

Choose whether to show, hide or reword this question based on where, when and by whom the survey is completed