• Anxiety screening tool

  • Format: (000) 000-0000.
  • Over the last two weeks, how often have you beenbothered by the following problems?

  • Feeling nervous, anxious, or on edge.
  • Not being able to stop or control worrying.
  • Worrying too much about different things.
  • Trouble relaxing.
  • Being so restless that it’s hard to sit still.
  • Becoming easily annoyed or irritable.
  • Feeling afraid as if something awful might happen.
  • This assesment is only a screening tool. Only a licensed provider can diagnose you with anxiety.

    0–4: Minimal anxiety - Monitor - does not require treatment

    5–9: Mild anxiety - Monitor

    10–14: Moderate anxiety - Possible clinically significant condition. An evaluation might be useful

    15–21: Severe anxiety - Active treatment probably warranted. 

  • Should be Empty: