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Anxiety Symptoms Inventory (21 questions)
Below is a list of common symptoms of anxiety. Please carefully read each symptom and indicate how much you have been bothered by that symptom during the past month, including today.
*
Indicates required field
Name
*
First
Last
Email
*
Phone Number
*
Numbness or tingling
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Feeling hot
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Wobbliness in legs
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Unable to relax
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Fear of worst happening
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Dizzy or lightheaded
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Heart pounding / racing
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Unsteady
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Terrified or afraid
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Nervous
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Feeling of choking
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Hands trembling
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Shaky / Unsteady
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Fear of losing control
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Difficulty in breathing
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Fear of dying
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Scared
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Indigestion
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Faint / lightheaded
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Face flushed
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Hot / cold sweats
*
Not at all
Mildly, but it didn't bother me much
Moderately - it wasn't pleasant at times
Severely - it bothered me a lot
Submit
Home
About Us
Nancy Bunt
Hours
Directions
Rates
Health Insurance Information
Services
Reiki Treatment
Reiki Training
>
Reiki For The Self
Reiki For Others
Reiki Second Degree
Reiki Master Teacher
Reiki Consulting
iRest® Self-Inquiry Meditation
SoulCollage®
TRE®
Live Workshops
Online Courses
Free Meditation Library
Online Booking
Store
Blog
Contact