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Kids Plus Pediatrics
  • Pre-Visit
  • Payments
    • Online Payments
    • Kids + Autopay
      • AutoPay Authorization
      • Kids + AutoPay FAQ
  • Patient Portal
  • Your Visit
    • New Patient Info
      • Getting Started
      • Kids + Family Guide
      • Behind the Scenes
    • Forms
    • Office Policies
      • Affordable Care Act Info
      • Financial Policy
      • Newborn Insurance Reminder
      • Non-Discrimination Policy
      • Screenings & Procedures
      • Split Family Policy
    • Patient Portal
    • Pre-Visit Questionnaires
    • Types of Visits
      • Well Visits
      • Walk-Ins
      • Virtual Visits
      • Fussy Baby
      • Dental Days
      • Adoption
      • Kids + Fit
      • Young Adult Care
    • Vaccinations
      • Vaccine Policy Statement
      • Vaccine Information Statements
      • COVID Vaccines
      • Flu Vaccines & Flu Clinics
      • HPV Vaccine: Cancer Prevention
  • Pediatrics +
    • Overview
    • Adoption
    • Behavioral Health
    • Breastfeeding
    • Concussions
    • Immunization
    • Infant Sleep
    • Nutrition & Fitness
  • Parent Resources
    • Overview
    • Blog
    • Classes
    • Doctors’ Notes
    • Podcast
    • Videos
  • Providers
  • About
    • Our Story
    • Our Mission & Vision
    • Advocacy
    • In the News
    • Kids + Jobs
    • Kids + Team
    • Kids + Teaching
    • Making Movies
    • Our Favorite Children’s Books
  • Offices
    • Overview
    • Cranberry/Seven Fields
    • Pleasant Hills
    • Squirrel Hill/Greenfield

PHQ-9

Your Name(Required)
MM slash DD slash YYYY
MM slash DD slash YYYY
Instructions & Acknowledgment(Required)
This questionnaire relies on self-reporting -- so answer the questions by yourself without any parental involvement. Your answers will remain confidential when you submit them to us at Kids Plus.

Please select one response for each question. Over the last 2 weeks, how often have you been bothered by any of the following problems...?
1. Little interest or pleasure in doing things.(Required)
2. Feeling down, depressed, or hopeless(Required)
3. Trouble falling or staying asleep, or sleeping too much(Required)
4. Feeling tired or having little energy(Required)
5. Poor appetite or overeating(Required)
6. Feeling bad about yourself, or that you are a failure, or that you have let yourself or your family down(Required)
7. Trouble concentrating on things, such as reading news or watching television(Required)
8. Moving or speaking so slowly that other people could have noticed. Or the opposite -- being so fidgety or restless that you've been moving around a lot more than usual(Required)
9. Thoughts that you would be better off dead, or of hurting yourself(Required)
10. If you checked any problems above, how difficult have these problems made it for you to go to work, take care of things at home, or get along with other people?(Required)
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Contact or visit us.

Cranberry/Seven Fields
671 Castle Creek Drive
Seven Fields, PA 16046 USA

P: 724.761.2020

F: 724.778.8959

Pleasant Hills
810 Clairton Blvd.
Pittsburgh, PA 15236 USA

P: 412.466.5004

F: 412.466.7137

Squirrel Hill/Greenfield
4070 Beechwood Blvd.
Pittsburgh, PA 15217 USA

P: 412.521.6511

F: 412.521.6512

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