The Patient Health Questionnaire PHQ-9 opens with fields for the "Please provide the patient's full name or identification number." question and the "What is today's date for this assessment?" question, anchoring each response to a specific patient and appointment. The nine symptom-frequency questions that follow cover the core PHQ-9 criteria — low mood, sleep disturbance, fatigue, appetite changes, feelings of worthlessness, concentration difficulties, psychomotor changes, and thoughts of self-harm — each offering four single-choice answers from 0 (not at all) to 3 (nearly every day), reflecting frequency over the past two weeks, so the healthcare provider can calculate a total severity score. The questions are sequenced to match the standard clinical PHQ-9 order, keeping the symptom sequence consistent across assessments. The Ending invites respondents to discuss their answers with a qualified healthcare professional and explains that no diagnosis, total score, or care-team alert is provided.
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Practitioners can review the nine symptom-frequency answers and calculate a score separately to support a clinical conversation.
Clinics can use the date and patient identifier alongside the nine frequency answers to compare symptom reports across appointments.
Providers can collect a symptom self-report before a consultation. Clinical assessment and any scoring remain separate from the form.
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