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Depression Screening

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Please note, all fields are required.

Multipage

Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual
Your response to this question indicates you may be at risk for harming yourself or someone else. Are you in crisis? Please call 911 or the National Suicide Prevention Hotline at 1-800-273-TALK or go immediately to the nearest emergency room.

Survey Questions
Before you get to your results, please take a moment to answer the following optional questions. If you aren’t comfortable sharing any or all of the information, you can click “submit” right away. Otherwise, your answers will help us better understand how we can achieve our mission. Don’t worry; we won’t be able to identify you based on this information.
Please note that we cannot respond if you entered “other.” If you are in crisis, please call 911 or the National Suicide Prevention Hotline at 1-800-273-TALK or go immediately to the nearest emergency room.

2000 N. Beauregard Street,
6th Floor Alexandria, VA 22311

Phone (703) 684.7722

Toll Free (800) 969.6642

Fax (703) 684.5968

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