Patient Health Questionnaire (PHQ-9)

If you have been advised by the surgery to submit a mental health review (PHQ-9) please use this form.

This form should not be used to access urgent help and may take up to 5 working days to be processed. If you require urgent help regarding your mental health, please visit ‘I need help now’ or speak to one of our medical receptionists by calling


Mental Health Review

Mental Health Review

About You

Please use this date format: DD/MM/YYYY.
Please let us know your preferred contact number in case we need to contact you.

Mental Health Review

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