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[email protected]
1075 STEPHENSON AVE. SUITE C OCEANPORT, NJ 07757
About
Who are We?
Our Team
Gallery
Services
Programs
Resources
Unity Media
Blogs
Events
News
Get HELP
Patient Depression Questionnaire
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Little interest or pleasure in doing things
Nearly Everyday
First choice
More than half the days
Several days
Not at all
Feeling down, depressed or hopeless
Nearly Everyday
First choice
More than half the days
Several days
Not at all
Trouble falling or staying asleep, or sleeping too much
Nearly Everyday
First choice
More than half the days
Several days
Not at all
Feeling tired or having little energy
Nearly Everyday
First choice
More than half the days
Several days
Not at all
Poor appetite or overeating
Nearly Everyday
First choice
More than half the days
Several days
Not at all
Feeling bad about yourself — or that you are a failure or have let yourself or your family down
Nearly Everyday
First choice
More than half the days
Several days
Not at all
Trouble concentrating on things, such as reading the newspaper or watching television
Nearly Everyday
First choice
More than half the days
Several days
Not at all
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
Nearly Everyday
First choice
More than half the days
Several days
Not at all
Thoughts that you would be better off dead or of hurting yourself in some way
Nearly Everyday
First choice
More than half the days
Several days
Not at all
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?
Nearly Everyday
First choice
More than half the days
Several days
Not at all
First name
Date of visit
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Mental illness and addiction are not choices, but recovery is.
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