PHQ-9 RESULT

Date: [Date]
Patient: [Name or ID, age]
Completed by: [Patient on paper, patient online, or read aloud by clinician; interpreter if used]
Reason: [Screening, follow-up of known depression, or treatment review]

SCORES
Items 1 to 9: [Score for each item, 0 to 3]
Total: [0 to 27]
Band: [Minimal, mild, moderate, moderately severe, or severe]
Item 9: [Score, and the risk assessment done if above 0]
Difficulty, item 10: [Not difficult at all, somewhat, very, or extremely difficult]

TREND
Previous scores: [Dates and totals]
Change from baseline: [Points and percent; response or remission if it applies]

CLINICAL PICTURE
Interview findings: [What the conversation added: duration, impairment, other causes considered]
Impression: [Working diagnosis or screen result]

PLAN
Next step: [Watch and repeat, start or change treatment, refer]
Repeat PHQ-9: [Date or interval]

Clinician: [Name, credentials]