Depression

1. Do you have poor appetite with weight loss?

Yes No

2. Do you have increased appetite with weight gain

Yes No

3. Do you experience difficulty sleeping?

Yes No

4. Do you feel lack of energy?

Yes No

5. Do you experience lack of concentration?

Yes No

6. Are you irritable?

Yes No

7. Do you feel like you are constantly thinking about the past?

Yes No

8. Does anyone in your family has or ever had depression?

Yes No