Patient Health Questionnaire

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*Q1. Your name (this will be attached to a person's response when the survey is completed anonymously)

*Q2. Over the last two weeks, how often have you been bothered by any of the following problems? (Text)

*Q3. Little interest or pleasure in doing things? (single choice)

Question Settings ▼

Not at all	Several days	Every day

Dropdown List used: Little interest or pleasure in doing things?

*Q4. Feeling tired or having little energy? (single choice)

Question Settings ▼

Not at all	Several days	Every day

Dropdown List used: Feeling tired or having little energy?

*Q5. Poor appetite or overeating? (single choice)

Question Settings ▼

Not at all	Several days	Every day

Dropdown List used: Poor appetite or overeating?

*Q6. Feeling bad about yourself - or that you are a failure or have let yourself or your family down? (single choice)

Question Settings ▼

Not at all	Several days	Every day

Dropdown List used: Feeling bad about yourself - or that you are a failure or have let yourself or your family down?

Organisations using the survey

Beond Ibogaine Treatment

Patient Health Questionnaire

Makerble® Strategies

Discover insights you never had time to find

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*Q1. Your name (this will be attached to a person's response when the survey is completed anonymously)

*Q2. Over the last two weeks, how often have you been bothered by any of the following problems? (Text)

*Q3. Little interest or pleasure in doing things? (single choice)

*Q4. Feeling tired or having little energy? (single choice)

*Q5. Poor appetite or overeating? (single choice)

*Q6. Feeling bad about yourself - or that you are a failure or have let yourself or your family down? (single choice)

Organisations using the survey

More impact, less admin

Patient Health Questionnaire

Makerble® Strategies

Discover insights you never had time to find

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Tags

*Q1. Your name (this will be attached to a person's response when the survey is completed anonymously)

*Q2. Over the last two weeks, how often have you been bothered by any of the following problems? (Text)

*Q3. Little interest or pleasure in doing things? (single choice)

*Q4. Feeling tired or having little energy? (single choice)

*Q5. Poor appetite or overeating? (single choice)

*Q6. Feeling bad about yourself - or that you are a failure or have let yourself or your family down? (single choice)

Organisations using the survey

Choose a Project

Select a Project