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Private, consultant-led clinic. Not part of the NHS memory service. No GP referral needed.

Sheffield Memory Service & Geriatric Care Dr Pravin Jha · Consultant Geriatrician & Memory Specialist
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Patient questionnaire

Worry and Anxiety Questionnaire (GAI-20)

Twenty short agree-or-disagree statements about worry and anxiety, based on how you have felt over the past week. A relative can help with reading or typing; the answers should reflect your own feelings. It takes 3–5 minutes.

This form is for your appointment with Dr Jha. It is not checked out of hours, so please don’t use it for anything urgent: call 999 in an emergency, or NHS 111 or your GP for other urgent problems.

Please answer the items according to how you have felt in the last week.

Choose Agree if you mostly agree that the item describes you, or Disagree if you mostly disagree.

Your details

Questions

1. I worry a lot of the time.
2. I find it difficult to make a decision.
3. I often feel jumpy.
4. I find it hard to relax.
5. I often cannot enjoy things because of my worries.
6. Little things bother me a lot.
7. I often feel like I have butterflies in my stomach.
8. I think of myself as a worrier.
9. I can't help worrying about even trivial things.
10. I often feel nervous.
11. My own thoughts often make me anxious.
12. I get an upset stomach due to my worrying.
13. I think of myself as a nervous person.
14. I always anticipate the worst will happen.
15. I often feel shaky inside.
16. I think that my worries interfere with my life.
17. My worries often overwhelm me.
18. I sometimes feel a great knot in my stomach.
19. I miss out on things because I worry too much.
20. I often feel upset.
Consent

Your answers are stored securely on this website for Dr Jha. They are copied into your clinical record and deleted from the website within 90 days. Privacy notice

Back to the pre-consultation questionnaires

Back to the 6-monthly review questionnaires