General Clinic
In-person clinics
Doctors
Telemedicine
Fitness Vital Sign
Book an appointment
Group medical appointments
Mental health clinic
Health retreat
About OWIP
Join OWIP
CHO NATUROPATHIC
General Clinic
In-person clinics
Doctors
Telemedicine
Fitness Vital Sign
Book an appointment
Group medical appointments
Mental health clinic
Health retreat
About OWIP
Join OWIP
Name
*
First Name
Last Name
List of medications and supplements
Are you doing mental health counseling / seeing a psychotherapist?
*
Yes
No
Do you have suicidal thoughts?
Yes
No
PHQ-9
How often have they been bothered by the following over the past 2 weeks?
Little interest or pleasure in doing things?
*
Not at all
Several days
More than half the days
Nearly every day
Feeling down, depressed, or hopeless?
*
Not at all
Several days
More than half the days
Nearly every day
Trouble falling or staying asleep, or sleeping too much?
*
Not at all
Several days
More than half the days
Nearly every day
Feeling tired or having little energy?
*
Not at all
Several days
More than half the days
Nearly every day
Poor appetite or overeating?
*
Not at all
Several days
More than half the days
Nearly every day
Feeling bad about yourself — or that you are a failure or have let yourself or your family down?
*
Not at all
Several days
More than half the days
Nearly every day
Trouble concentrating on things, such as reading the newspaper or watching television?
*
Not at all
Several days
More than half the days
Nearly every day
Moving or speaking so slowly that other people could have noticed? Or so fidgety or restless that you have been moving a lot more than usual?
*
Not at all
Several days
More than half the days
Nearly every day
Thoughts that you would be better off dead, or thoughts of hurting yourself in some way?
*
Not at all
Several days
More than half the days
Nearly every day
GAD-7
How often have they been bothered by the following over the past 2 weeks?
Feeling nervous, anxious, or on edge
*
Not at all
Several days
More than half the days
Nearly every day
Not being able to stop or control worrying
*
Not at all
Several days
More than half the days
Nearly every day
Worrying too much about different things
*
Not at all
Several days
More than half the days
Nearly every day
Trouble relaxing
*
Not at all
Several days
More than half the days
Nearly every day
Being so restless that it's hard to sit still
*
Not at all
Several days
More than half the days
Nearly every day
Becoming easily annoyed or irritable
*
Not at all
Several days
More than half the days
Nearly every day
Feeling afraid as if something awful might happen
*
Not at all
Several days
More than half the days
Nearly every day
Email
Thank you!