Patient Health Questionnaire (PHQ-9)

Thank-you for using our secure online questionnaire to see if you qualify for TMS Therapy. Please take your time and fill out the form completly and carefully. Click the "Submit" button at the end when completed.
* = Required Field.
Over the last 2 weeks, how often have you been bothered by any of the following problems? *
 Not at allSeveral daysMore than half the daysNearly every day
1. Little interest or pleasure in doing things
2. Feeling down, depressed, or hopeless
3. Trouble falling or staying asleep, or sleeping too much
4. Feeling tired or having little energy
5. Poor appetite or overeating
6. Feeling bad about yourself — or that you are a failure or have let yourself or your family down
7. Trouble concentrating on things, such as reading the newspaper or watching television
8. Moving or speaking so slowly that other people could have noticed? Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual
9. Thoughts that you would be better off dead or of hurting yourself in some way
Please Note

If you have answered "Not at all" to all of the above questions then TMS Therapy is not appropriate for you at this time. Please check back in the future.

If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? *
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