Adolescent Depression Screening (PHQ-A)
Adolescent Depression Screening (PHQ-A)
Confidential depression screening for teens ages 12-17 using the modified PHQ-A scale.
Confidentiality & Crisis Notice
Teen Information
Full name *
Your answer
Date of birth
School grade
Parent/guardian contact email
Symptoms in the Past Two Weeks
Feeling down, depressed, irritable, or hopeless
Not at all
Several days
More than half the days
Nearly every day
+ 9 more questions
About this template
Confidential depression screening for teens ages 12-17 using the modified PHQ-A scale.
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