Depression Survey
Choose the answer which best describes you and your planting process.
Administration
Q1 = Please enter the following: Name, Address, Phone Numbers, Organization
First Name:
Last Name:
Organization:
Questions
Q2 = Your date of birth:
Q3 = Baby's Date of Birth
Q4 = In the past seven days: I have been able to laugh and see the funny side of things
As much as I always could.
Not quite so much now
Definitely not so much now
Not at all
Questions
Q5 = I have looked forward with enjoyment to things
As much as I ever did
Rather less than I used to
Definitely less than I used to
Hardly at all
Q6 = I have blamed myself unnecessarily when things
Yes, most of the time
Yes, some of the time
Not very often
No, never
Q7 = I have been anxious or worried for no good reason
No, not at all
Hardly ever
Yes, sometimes
Yes, very often
Q8 = I have felt scared or panicky for no very good reason
Yes, quite a lot
Yes, sometimes
No, not much
No, not at all
Questions
Q9 = Things have been getting on top of me
Yes, most of the time I haven't been able to cope at all
Yes, sometimes I haven't been coping as well as usual
No, most of the time I have copied quite well
No, I have been coping as well as ever
Q10 = I have been so unhappy that I have had difficulty sleeping
Yes, most of the time
Yes, sometimes
Not very often
No, not at all
Q11 = I have felt sad or miserable
Yes, most of the time
Yes, quite often
Not very often
No, not at all
Q12 = I have been so unhappy that I have been crying
Yes, most of the time
Yes, quite often
Only occasionally
No, never
Q13 = The thought of harming myself has occurred to me
Yes, quite often
Sometimes
Hardly ever
Never
Depression Survey