Anxiety Rating Scale

I feel tense, nervous, restless, or agitated

I feel afraid for no apparent reason

I worry about bad things that might happen to me

I have difficulty falling asleep, staying asleep or waking up early

I have difficulty eating too much, too little or digesting my food

I wish I knew a way to make myself more relaxed

I have difficulty with my concentration, memory or thinking

I would say I am anxious much of the time

From time to time I have experienced a racing heartbeat, cold hands or feet, dry mouth, sweating, tight muscles, difficulty breathing, numbness, frequent urination

I wish I could be as relaxed with myself as others seem to be