Smile Miles Card
Task or event you're putting off
Score
Please Select
1
2
3
4
5
6
7
8
9
10
Level of anxiety
Task or event you're putting off
Score
Please Select
1
2
3
4
5
6
7
8
9
10
Level of anxiety
Task or event you're putting off
Score
Please Select
1
2
3
4
5
6
7
8
9
10
Level of anxiety
Task or event you're putting off
Score
Please Select
1
2
3
4
5
6
7
8
9
10
Level of anxiety
Task or event you're putting off
Score
Please Select
1
2
3
4
5
6
7
8
9
10
Level of anxiety
Task or event you're putting off
Score
Please Select
1
2
3
4
5
6
7
8
9
10
Level of anxiety
Task or event you're putting off
Score
Please Select
1
2
3
4
5
6
7
8
9
10
Level of anxiety
Complete each task and monitor your score out of 100
Score
Please Select
1
2
3
4
5
6
7
8
9
10
Level of anxiety
Notes
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