PHQ-9 and GAD-7 Online: Scored Questionnaires on the Chart (2027)

Sending the PHQ-9 and GAD-7 online saves more than paper. When the patient answers before the session, the score is already on the chart when you open it, next to every earlier score, so you can see at a glance whether things are getting better. This guide covers how both questionnaires are scored according to their authors, why software must score them exactly that way, and how to track results over time. It also lists the other scored measures ClinikForms offers.

Clinical note: The PHQ-9 and GAD-7 are screening and severity tools. A score or band is not a diagnosis. Interpret results with a clinical assessment, and have a protocol for responding to any answer that indicates risk.

Quick Answer

The PHQ-9 has nine items scored 0 to 3, for a total of 0 to 27. Its authors describe scores of 5, 10, 15 and 20 as mild, moderate, moderately severe and severe depression. The GAD-7 has seven items scored 0 to 3, for a total of 0 to 21, with cut points of 5, 10 and 15 for mild, moderate and severe anxiety. To run them online, use a tool that scores them exactly as published, files each score on the patient's chart, and shows the trend over time. ClinikForms, in ClinikEHR, does this on the Essential plan and above.

Note: For a wider tour of assessment tools, see our top 20 auto-scored mental health assessments. For intake packs in psychiatry and therapy, see best intake forms for psychiatry and therapy. This post focuses on scoring and tracking.

PHQ-9 Scoring

The PHQ-9 was published by Kroenke, Spitzer and Williams in the Journal of General Internal Medicine in 2001. Each of its nine items asks how often a problem has bothered the patient over the last two weeks, scored from 0 ("not at all") to 3 ("nearly every day"). The total runs from 0 to 27. The authors report that "PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively" (Kroenke et al., 2001, PMC, checked September 2026).

Item 9 needs its own attention. The ninth item asks about thoughts of death or self-harm. Any answer above zero should get a clinician's attention whatever the total, following your practice's safety protocol.

GAD-7 Scoring

The GAD-7 was published by Spitzer, Kroenke, Williams and Löwe in the Archives of Internal Medicine in 2006. It has seven items scored 0 to 3, for a total of 0 to 21. The authors write that cut points of 5, 10 and 15 "might be interpreted as representing mild, moderate, and severe levels of anxiety". They identified 10 as the cut point for identifying generalized anxiety disorder, with 89% sensitivity and 82% specificity in their study (Spitzer et al., 2006, JAMA Network, checked September 2026).

A score of 10 or more is a signal to assess further, not a diagnosis of an anxiety disorder.

Why Scoring Exactly as Published Matters

The bands above only mean something when the questionnaire is given and scored the way its authors validated it. Small changes break that link:

• Changed items. Rewording, dropping or adding questions changes what the total measures.
• Changed scales. Scoring 1 to 4 instead of 0 to 3 moves every total up and puts patients in the wrong band.
• Missing answers. Counting a blank as zero makes a patient look better than they are.
• Silent rule changes. If software changes how it scores, old and new totals can end up on the same line of a chart.

ClinikForms is built around this problem. Its Help Center describes seven measures (PEG, SWLS, ASRS v1.1, CUDOS, DASS-21, DASH and DES-II) that are now scored the way their authors publish them. When a response can't be scored as published (the wrong number of questions, an answer outside the scale, or too many blanks), it's kept but recorded as Recorded but not scored, with the reason. In the Help Center's words: "No score is better than a wrong one." When scoring rules changed, older scores kept the rule they were scored under and sit on a separate chart headed Scored under the previous rule, so scores on different scales are never drawn on the same line.

Tracking Scores Over Time on the Chart

One score is a snapshot. The trend is what shapes treatment. In ClinikForms:

1. Make the form a scored measure. On the form's Settings tab, choose the measure under Clinical measure and give each choice question its points per option.
2. Send it. Send it from the chart, from a link, through the patient portal, or automatically with appointments using Sharable Documents, where "Clinical Outcomes & Measures" is its own section.
3. Read the Measures tab. When the response arrives, the score is added to the patient's Measures tab, and each measure has its own chart over time.
4. Check the direction. Beside each chart, Since Baseline and Since Last show how many points the score has moved. For the PHQ-9 and GAD-7, where lower is better, a fall shows green and a rise shows red.

You can also use a measure as a note template, and a form automation can notify the clinic when the score meets a condition you set, for example when a PHQ-9 total reaches the severe band.

A simple measurement routine

• Baseline: PHQ-9 and GAD-7 at intake.
• Follow-up: repeat at a fixed interval your clinicians choose, sent automatically before the session.
• Review: look at the Since Baseline figure at each treatment-plan review.
• Act: agree in advance what change or level prompts a plan review.

The Other Scored Measures in ClinikForms

The Help Center lists 17 scored measures:

Some have their own scoring. The DASS-21 gives three separate scores (Depression, Anxiety and Stress), each out of 42, with no single total. The ASRS v1.1 gives a positive or negative screen from its first six questions. For the SWLS a higher score is better, so its arrows are reversed. The ACE counts past experiences, so its arrow has no colour.

Building the PHQ-9 in ClinikForms: The Details That Matter

The four steps above hide a few choices that decide whether scores can be trusted:

• Use the published wording and response options. Four options per item, worth 0, 1, 2 and 3 points, set with Points per option on each choice question. Don't add an "Other" option.
• Make every scored item required. If someone selects Next with a required question empty, the form lists what's missing and takes them to it. That prevents blanks at the source. A response that still can't be scored is recorded with the reason, not scored wrongly.
• Leave everything else unscored. A name, a date or a free-text "anything else?" question is left out of the score automatically.
• Send it by invite, not a plain link. Choosing a patient when you send is what files the answers to their chart. A form set to Patients only is also listed in the patient portal.
• Keep the item 9 route human. A form automation with a condition on the ninth item's answer can notify the clinic, but it runs once, when the response is first submitted, and a practice that has switched off that notification category won't see it (Help Center: Form automation, checked September 2026). Alerts support your safety protocol. They don't replace it.

A Worked Scoring Example

These answers are made up, to show the arithmetic. At intake a patient's nine PHQ-9 answers are 2, 2, 1, 3, 1, 2, 1, 2 and 0. The total is 14, in the authors' moderate band (10–14), and item 9 is 0. At a later follow-up the answers are 1, 1, 1, 2, 0, 1, 1, 1 and 0, for a total of 8, in the mild band. On the Measures tab, Since Baseline would show the score down 6 points in green, because a lower PHQ-9 score is better.

A change of band like this is a prompt for a conversation with the patient, not a conclusion. Clinical judgement decides what it means.

Common Mistakes When Running Questionnaires Online

• Rewording items to match your practice's tone. The published cut points only apply to the published questions.
• Scoring on the wrong scale. A 1-to-4 or 1-to-5 scale moves every total and every band. Use choice questions with points per option set to 0 to 3.
• Letting results sit unread. Each clinician can choose Every response or a Daily digest under Notify me about new responses. Neither shows the answers themselves, so open the response to read them.
• Emailing answers around the clinic. Automations leave answers out of emails by default, and a rule that would send them outside your practice's own inbox asks you to confirm it first. Keep scores on the chart.
• Changing the measure mid-course. Swapping a validated questionnaire for a home-made version breaks the trend line you're trying to read.

What to Ask Any Vendor About Scored Measures

1. Is each measure scored exactly as its authors publish it, and can you show me the rule?
2. What happens to a response with blanks or answers outside the scale?
3. Do scores land on the patient's chart with a trend, or in a separate report?
4. If you change a scoring rule, what happens to older scores?
5. Will you sign a BAA that covers the questionnaires and the scores?

Product Insight: ClinikForms Scored Measures

ClinikForms runs inside ClinikEHR under the same BAA as the chart. Scored clinical measures are on Essential ($99.90/month) and Team ($250/month). The Free plan includes forms (10 published, 100 responses each) but not scored measures. A 30-day Essential trial costs $29.90. Being honest about the limits: ClinikForms scores and charts. It doesn't diagnose, and it doesn't choose measures for you. See ClinikForms & eSignatures, clinical notes, patient management and our pricing page.

Frequently Asked Questions (FAQs)

1. How is the PHQ-9 scored?

Nine items, each scored 0 to 3, are added together for a total of 0 to 27. The authors describe 5, 10, 15 and 20 as the cut points for mild, moderate, moderately severe and severe depression.

2. How is the GAD-7 scored?

Seven items, each scored 0 to 3, are added for a total of 0 to 21. Cut points of 5, 10 and 15 indicate mild, moderate and severe anxiety, and 10 was the authors' cut point for identifying generalized anxiety disorder.

3. Is a PHQ-9 or GAD-7 score a diagnosis?

No. Both are screening and severity tools. A diagnosis needs a clinical assessment.

4. Can patients complete the PHQ-9 online before a session?

Yes. In ClinikForms you can send it from the chart or the patient portal, or automatically with appointments. The score is added to the patient's Measures tab when they submit.

5. How do I track PHQ-9 scores over time?

Use software that stores every score on the chart. ClinikForms draws a chart for each measure and shows how many points the score has moved since the baseline and since the last assessment.

6. Which plan includes scored measures?

Scored clinical measures are on ClinikEHR's Essential plan ($99.90/month) and above. The Free plan includes forms but not scored measures.

Conclusion

The PHQ-9 and GAD-7 are short, well validated and easy to run online, but only if they're scored exactly as their authors published them. Put them on the chart, repeat them at a steady interval, and read the trend, not a single number. Keep the clinical frame clear: these are screening and severity tools, and the clinician makes the diagnosis.

Key takeaways:

• PHQ-9: 0 to 27, with cut points at 5, 10, 15 and 20. GAD-7: 0 to 21, with cut points at 5, 10 and 15
• Watch PHQ-9 item 9 on its own, whatever the total
• Score exactly as published; an unscorable response should say why
• Track the trend since baseline and since the last assessment on the chart
• ClinikForms scores 17 measures on Essential and above, under the same BAA as the chart

Ready to put scores on the chart? Try ClinikEHR free, explore our pricing, or book a free demo.

Disclaimer: This article is educational. The PHQ-9 and GAD-7 are screening tools, not diagnostic instruments, and scores must be interpreted by a qualified clinician. If a patient may be at risk of harm, follow your emergency and safety protocols.

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