Math Anxiety Screener

Parents, by allowing your teen to complete this form, you acknowledge and consent to their participation and the use of their responses for the intended purpose. Your teen’s privacy and confidentiality will be respected throughout the process.
Parent's Name*

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Parent's Email*
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Student's First Name*
Today's Date

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Directions:

Students, please read each statement and click the circle that best describes your experiences. Remember, there is no right or wrong answer. Just your truth :)

	I Most Definitely Disagree (1)	I Somewhat Disagree (2)	I'm Neutral (3)	I Somewhat Agree (4)	I Absolutely Agree (5)
1. I cringe when I have to go to math class.
2. I'm uneasy about going to the board in a math class.
3. I'm afraid to ask questions in math class.
4. I'm always worried about being called on in math class.
5. I understand math now, but I worry that it's going to get difficult soon.
6. I tend to zone out in math class.
7. I fear math tests more than any other kind.
8. I don't know how to study for math tests.
9. It's clear to me in math class, but when I go home it's like I was never there.
10. I'm afraid I won't be able to keep up with the rest of the class.

Math Anxiety Results
I understand that by submitting this Math Anxiety Screener, I give permission for Dynell Garron or her team to send helpful communication about the results.*

Yes
When you hit "Submit," your score will be sent to the email you entered above and you will go directly to our Score Results page.
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Directions: