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Home
About
Services
Applied Behavior Analysis
Evaluations
Online Therapy
Resources
E-Learning
Blog
Insurances
SCREEN YOUR CHILD
REFER A CLIENT
CONTACT US
Get Help
305 827 2822
DEPRESSION SCREENING
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Evaluations
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SCREEN YOUR CHILD
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DEPRESSION SCREENING
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Name
*
First
Last
Email
*
Phone
1. Little interest or pleasure in doing things
Not at All
Several Days
More than half the days
Nearly Every Day
2. Feeling down, depressed, or hopeless
Not at All
Several Days
More than half the days
Nearly Every Day
3. Trouble falling or staying asleep, or sleeping too much
Not at All
Several Days
More than half the days
Nearly Every Day
4. Feeling tired or having little energy
Not at All
Several Days
More than half the days
Nearly Every Day
5. Poor appetite or overeating
Not at All
Several Days
More than half the days
Nearly Every Day
6. 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
7. 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
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
Not at All
Several Days
More than half the days
Nearly Every Day
9. Thoughts that you would be better off dead, or of hurting yourself
Not at All
Several Days
More than half the days
Nearly Every Day
10. If you checked off any problems, how difficult have these problems made it for you at work, home, or with other people?
Not Difficult at All
Somewhat Difficult
Very Difficult
Extremely Difficult
Please note: Online screening tools are not diagnostic instruments. You are encouraged to share your results with a physician or healthcare provider.
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