Anxiety Assessment

Over the last 2 weeks, how often have you been bothered by:
Feeling nervous, anxious or on the edge
Not at all
Several days
More than half the days
Nearly every day
Over the last 2 weeks, how often have you been bothered by:
Not being able to stop or control worrying
Not at all
Several days
More than half the days
Nearly every day
Over the last 2 weeks, how often have you been bothered by:
Worrying too much about different things
Not at all
Several days
More than half the days
Nearly every day
Over the last 2 weeks, how often have you been bothered by: 
Trouble relaxing
Not at all
Several days
More than half the days
Nearly every day
Over the last 2 weeks, how often have you been bothered by: 
Being so restless that it is hard to sit still
Not at all
Several days
More than half the days
Nearly every day
Over the last 2 weeks, how often have you been bothered by: 
Becoming easily annoyed or irritable
Not at all
Several days
More than half the days
Nearly every day
Over the last 2 weeks, how often have you been bothered by: 
Feeling afraid as if something awful might happen
 
Not at all
Several days
More than half the days
Nearly every day
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