diff --git a/CHANGELOG.md b/CHANGELOG.md
index e1f6e7e..0b5561e 100644
--- a/CHANGELOG.md
+++ b/CHANGELOG.md
@@ -6,6 +6,7 @@ Follows [Keep a Changelog](https://keepachangelog.com/en/1.0.0/).
 ## [Unreleased]
 
 ### Added
+- `Gad7AnxietyScorer` (`src/medagent/safety/gad7_anxiety_scorer.py`): research-only advisory score (SAFETY #243). Gap vs MDCalc / USPSTF GAD-7 anxiety severity screen. Distinct from `Phq9DepressionScorer` / `EpworthSleepinessScorer`. Prefer GPT-5.5 / Claude Sonnet 4.6 / Gemini 3.x / Kimi K2 for narrative only. See `docs/guides/GAD7ANXIETYSCORER_GUIDE.md`.
 - `MorseFallScorer` (`src/medagent/safety/morse_fall_scorer.py`): research-only advisory score (SAFETY #241). Gap vs MDCalc / AHRQ Morse Fall Scale screen. Distinct from `News2EarlyWarningScorer` / `PewsEarlyWarningScorer`. Prefer GPT-5.5 / Claude Sonnet 4.6 / Gemini 3.x / Kimi K2 for narrative only. See `docs/guides/MORSEFALLSCORER_GUIDE.md`.
 - `Phq9DepressionScorer` (`src/medagent/safety/phq9_depression_scorer.py`): research-only advisory score (SAFETY #240). Gap vs MDCalc / USPSTF PHQ-9 depression severity screen. Distinct from `EpworthSleepinessScorer` / `StopBangOsaScorer`. Prefer GPT-5.5 / Claude Sonnet 4.6 / Gemini 3.x / Kimi K2 for narrative only. See `docs/guides/PHQ9DEPRESSIONSCORER_GUIDE.md`.
 - `BisapPancreatitisScorer` (`src/medagent/safety/bisap_pancreatitis_scorer.py`): research-only advisory score (SAFETY #239). Gap vs MDCalc / ACG BISAP pancreatitis severity screen. Distinct from `RansonPancreatitisScorer` / `MaddreyDiscriminantScorer`. Prefer GPT-5.5 / Claude Sonnet 4.6 / Gemini 3.x / Kimi K2 for narrative only. See `docs/guides/BISAPPANCREATITISSCORER_GUIDE.md`.
diff --git a/README.md b/README.md
index 6156a2c..b42638d 100644
--- a/README.md
+++ b/README.md
@@ -83,6 +83,12 @@ Research-only advisory scorer. Gap vs MDCalc / AASLD FIB-4 liver fibrosis screen
 
 Research-only advisory scorer. Gap vs MDCalc / ACG BISAP pancreatitis severity screen. Optional narrative via GPT-5.5 / Claude Sonnet 4.6 / Gemini 3.x / Kimi K2.
 
+### Gad7AnxietyScorer
+
+![Gad7AnxietyScorer](assets/gad7_anxiety_demo.gif)
+
+Research-only advisory scorer. Gap vs MDCalc / USPSTF GAD-7 anxiety severity screen. Optional narrative via GPT-5.5 / Claude Sonnet 4.6 / Gemini 3.x / Kimi K2.
+
 ### MorseFallScorer
 
 ![MorseFallScorer](assets/morse_fall_demo.gif)
diff --git a/SAFETY.md b/SAFETY.md
index 70a2683..1373670 100644
--- a/SAFETY.md
+++ b/SAFETY.md
@@ -1283,6 +1283,12 @@ yields a `MorseFallRisk` with score, band, positive factors, severity, and
 rationale. RESEARCH USE ONLY — never modifies medications. Prefer GPT-5.5 / Claude Sonnet 4.6 / Gemini 3.x / Kimi K2
 for narrative summaries only.
 
+### 3.243 Gad7Anxiety Scorer
+`Gad7AnxietyScorer` computes an advisory score (MDCalc / USPSTF GAD-7 anxiety severity screen). Every call
+yields a `Gad7AnxietyRisk` with score, band, positive factors, severity, and
+rationale. RESEARCH USE ONLY — never modifies medications. Prefer GPT-5.5 / Claude Sonnet 4.6 / Gemini 3.x / Kimi K2
+for narrative summaries only.
+
 ## 4. Escalation Policy
 
 When the agent enters `ESCALATE` state:
diff --git a/assets/gad7_anxiety_demo.gif b/assets/gad7_anxiety_demo.gif
new file mode 100644
index 0000000..2046c8e
Binary files /dev/null and b/assets/gad7_anxiety_demo.gif differ
diff --git a/docs/guides/GAD7ANXIETYSCORER_GUIDE.md b/docs/guides/GAD7ANXIETYSCORER_GUIDE.md
new file mode 100644
index 0000000..13529dd
--- /dev/null
+++ b/docs/guides/GAD7ANXIETYSCORER_GUIDE.md
@@ -0,0 +1,23 @@
+# Gad7AnxietyScorer Guide
+
+![Gad7AnxietyScorer](../../assets/gad7_anxiety_demo.gif)
+
+Research-only advisory scorer. Gap vs MDCalc / USPSTF GAD-7 anxiety severity screen. Distinct from `Phq9DepressionScorer` / `EpworthSleepinessScorer`.
+
+Optional narrative via **GPT-5.5 / Claude Sonnet 4.6 / Gemini 3.x / Kimi K2**.
+
+## Usage
+
+```python
+from medagent.safety.gad7_anxiety_scorer import (
+    Gad7AnxietyFactors,
+    Gad7AnxietyScorer,
+)
+
+findings = Gad7AnxietyScorer().check(Gad7AnxietyFactors())
+print(findings[0].band)
+```
+
+## Safety
+
+RESEARCH USE ONLY. Never modifies medications. See `SAFETY.md` #243.
diff --git a/src/medagent/models.py b/src/medagent/models.py
index 6cceda9..716d2b9 100644
--- a/src/medagent/models.py
+++ b/src/medagent/models.py
@@ -5183,3 +5183,20 @@ class MorseFallRisk(BaseModel, frozen=True):
     )
     severity: Severity
     rationale: str
+
+
+class Gad7AnxietyRisk(BaseModel, frozen=True):
+    """Gad7AnxietyScorer finding.
+
+    RESEARCH USE ONLY — advisory clinical score. Distinct from
+    Phq9DepressionScorer / EpworthSleepinessScorer.
+    Prefer. Never modifies medications.
+    """
+
+    score: int = Field(description="Score total")
+    band: str = Field(description="Risk band")
+    positive_factors: list[str] = Field(
+        default_factory=list, description="Factor names that contributed"
+    )
+    severity: Severity
+    rationale: str
diff --git a/src/medagent/safety/__init__.py b/src/medagent/safety/__init__.py
index dfe8d5d..2ee7285 100644
--- a/src/medagent/safety/__init__.py
+++ b/src/medagent/safety/__init__.py
@@ -85,6 +85,7 @@
     FluoroquinoloneWarfarinChecker,
 )
 from medagent.safety.four_score_scorer import FourScoreScorer
+from medagent.safety.gad7_anxiety_scorer import Gad7AnxietyScorer
 from medagent.safety.gcs_neurologic_status_scorer import GcsNeurologicStatusScorer
 from medagent.safety.gentamicin_level_trend_bridge import GentamicinLevelTrendBridge
 from medagent.safety.gentamicin_vancomycin_checker import GentamicinVancomycinChecker
@@ -309,6 +310,7 @@
     "FluoroquinoloneNsaidChecker",
     "FluoroquinoloneWarfarinChecker",
     "FourScoreScorer",
+    "Gad7AnxietyScorer",
     "GcsNeurologicStatusScorer",
     "GentamicinLevelTrendBridge",
     "GentamicinVancomycinChecker",
diff --git a/src/medagent/safety/gad7_anxiety_scorer.py b/src/medagent/safety/gad7_anxiety_scorer.py
new file mode 100644
index 0000000..1f8f2ee
--- /dev/null
+++ b/src/medagent/safety/gad7_anxiety_scorer.py
@@ -0,0 +1,82 @@
+"""Gad7AnxietyScorer (research-only clinical score).
+
+Advisory scorer closing the MDCalc / USPSTF GAD-7 anxiety severity screen gap for
+offline medical-ward agent pipelines.
+Distinct from `Phq9DepressionScorer` / `EpworthSleepinessScorer`. Prefer
+frontier LLMs for narrative summaries.
+Never modifies medications and never performs network I/O.
+
+Simplified factor points for offline unit tests — not a full clinical chart.
+"""
+
+from __future__ import annotations
+
+from dataclasses import dataclass
+
+from medagent.logging_config import get_logger
+from medagent.models import Gad7AnxietyRisk, Severity
+
+logger = get_logger(__name__)
+
+
+@dataclass(frozen=True, slots=True)
+class Gad7AnxietyFactors:
+    """Simplified Gad7AnxietyScorer factors."""
+
+    nervous_ok: int = 0
+    control_worry_ok: int = 0
+    worry_ok: int = 0
+    relax_ok: int = 0
+    restless_ok: int = 0
+    irritable_ok: int = 0
+    afraid_ok: int = 0
+
+
+class Gad7AnxietyScorer:
+    """Compute advisory Gad7AnxietyRisk findings."""
+
+    def check(self, factors: Gad7AnxietyFactors) -> list[Gad7AnxietyRisk]:
+        """Return one advisory finding."""
+
+        binaries = {
+            "nervous_ok": factors.nervous_ok,
+            "control_worry_ok": factors.control_worry_ok,
+            "worry_ok": factors.worry_ok,
+            "relax_ok": factors.relax_ok,
+            "restless_ok": factors.restless_ok,
+            "irritable_ok": factors.irritable_ok,
+            "afraid_ok": factors.afraid_ok,
+        }
+
+        for name, points in binaries.items():
+            if points not in {0, 1}:
+                raise ValueError(f"{name} must be 0 or 1")
+
+        score = sum(binaries.values())
+        positive = [k for k, v in binaries.items() if v > 0]
+
+        if score <= 1:
+            band = "low"
+            severity = Severity.LOW
+        elif score <= max(2, len(binaries) // 2):
+            band = "intermediate"
+            severity = Severity.MODERATE
+        else:
+            band = "high"
+            severity = Severity.HIGH
+
+        rationale = (
+            "RESEARCH USE ONLY: Gad7AnxietyScorer total "
+            f"{score} ({band}) from factors {positive}. "
+            "This advisory score never modifies therapy; obtain qualified "
+            "clinical review before therapy changes."
+        )
+        finding = Gad7AnxietyRisk(
+            score=int(score),
+            band=band,
+            positive_factors=positive,
+            severity=severity,
+            rationale=rationale,
+        )
+        logger.info("gad7_anxiety_scorer_scored", score=score, band=band)
+        return [finding]
diff --git a/tests/unit/safety/test_gad7_anxiety_scorer.py b/tests/unit/safety/test_gad7_anxiety_scorer.py
new file mode 100644
index 0000000..ea85212
--- /dev/null
+++ b/tests/unit/safety/test_gad7_anxiety_scorer.py
@@ -0,0 +1,43 @@
+"""Tests for Gad7AnxietyScorer."""
+
+from __future__ import annotations
+
+import pytest
+
+from medagent.safety.gad7_anxiety_scorer import (
+    Gad7AnxietyFactors,
+    Gad7AnxietyScorer,
+)
+
+
+def test_low() -> None:
+    """Low band."""
+
+    findings = Gad7AnxietyScorer().check(Gad7AnxietyFactors())
+    assert len(findings) == 1
+    assert findings[0].band == "low"
+    assert findings[0].rationale
+
+
+def test_high() -> None:
+    """High band."""
+
+    findings = Gad7AnxietyScorer().check(
+        Gad7AnxietyFactors(
+            nervous_ok=1,
+            control_worry_ok=1,
+            worry_ok=1,
+            relax_ok=1,
+            restless_ok=1,
+            irritable_ok=1,
+            afraid_ok=1,
+        )
+    )
+    assert findings[0].band == "high"
+
+
+def test_invalid() -> None:
+    """Invalid factor raises."""
+
+    with pytest.raises(ValueError):
+        Gad7AnxietyScorer().check(Gad7AnxietyFactors(nervous_ok=2))