Do I Need Anxiety Counselling? Self-check from Sana Psychological.

1

In the past 3 months, have you felt excessive worry or fear?* This field is required.

YESNO

2

In the past 3 months have you had changes to your eating or sleeping habits not created by a physical condition?* This field is required.

YESNO

3

In the past 3+ months have you had difficulty quieting your mind?* This field is required.

YESNO

4

In the past 3 months have you turned to substances, 'self-medicating,' rituals, or other behaviours to help you cope and reduce your uncomfortable feelings?* This field is required.

YESNO

5

In the past 3 months, have you had panic attacks?* This field is required.

YESNO

6

In the past 3 months have you spent a great deal of time thinking about ‘what ifs’ and the future?* This field is required.

YESNO

7

In the past 3 months, have you felt your feelings were out of control?* This field is required.

YESNO

8

In the past 3 months have you had difficulty relaxing and persistent muscle tension?* This field is required.

YESNO

9

Have you ever been diagnosed with an anxiety or anxiety-related condition (like Obsessive-Compulsive Disorder or Phobias)?* This field is required.

YESNO

10

Have you ever been prescribed an anti-anxiety medication?* This field is required.

YESNO

11

In the past 3 months, have you been engaging in rituals to help self-soothe (e.g., cleaning, picking)* This field is required.

YESNO

12

In the past 3 months, have you had out of the norm problems at work or in relationships?* This field is required.

YESNO

13

Do you feel your mental health has declined recently?* This field is required.

YESNO

14

What is your email? We'll send you more info.* This field is required.This is not a substitute for professional assessment and diagnosis. You may receive recommendations & free resources from Sana Psyc; you are free to unsubscribe at any time.

example@example.com

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Calculation

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Sorry :( This form is only availble in Canada

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