Depression Survey LEVEL 2—Depression—Adult Name* Age* Sex:* Male Female Date* MM slash DD slash YYYY If the measure is being completed by an informant, what is your relationship with the individual receiving care? In a typical week, approximately how many hours do you spend with the individual receiving care? In the past SEVEN (7) days..Select the option that best fits you. (1) Never, (2) Rarely, (3) Sometimes, (4) Often, (5) AlwaysI felt worthless. (1) Never, (2) Rarely, (3) Sometimes, (4) Often, (5) Always*Please enter a number from 1 to 5.I felt that I had nothing to look forward to. (1) Never, (2) Rarely, (3) Sometimes, (4) Often, (5) Always*Please enter a number from 1 to 5.I felt helpless. (1) Never, (2) Rarely, (3) Sometimes, (4) Often, (5) Always*Please enter a number from 1 to 5.I felt sad. (1) Never, (2) Rarely, (3) Sometimes, (4) Often, (5) Always*Please enter a number from 1 to 5.I felt like a failure. (1) Never, (2) Rarely, (3) Sometimes, (4) Often, (5) Always*Please enter a number from 1 to 5.I felt depressed. (1) Never, (2) Rarely, (3) Sometimes, (4) Often, (5) Always*Please enter a number from 1 to 5.I felt unhappy. (1) Never, (2) Rarely, (3) Sometimes, (4) Often, (5) Always*Please enter a number from 1 to 5.I felt hopeless. (1) Never, (2) Rarely, (3) Sometimes, (4) Often, (5) Always*Please enter a number from 1 to 5.HiddenRaw Score
