FREE ANXIETY TEST

Below is a list of common symptoms of anxiety. Please carefully read each item on the list. Indicate how much you have been bothered by the symptom during the past month, including today by clicking on the number. Once completed send your email address for FREE assessment.

Not at All Mildly Moderately Severely
Numbness or Tingling 0 1 2 3
Feeling Hot 0 1 2 3
Wobbliness in legs 0 1 2 3
Unable to relax 0 1 2 3
Fear of worst happening 0 1 2 3
Dizzy or lightheaded 0 1 2 3
Heart Pounding / racing 0 1 2 3
Unsteady 0 1 2 3
Terrified or afraid 0 1 2 3
Nervous 0 1 2 3
Feeling of choking 0 1 2 3
Hands Trembling 0 1 2 3
Shaky/Unsteady 0 1 2 3
Fear of losing control 0 1 2 3
Difficulty in Breathing 0 1 2 3
Fear of Dying 0 1 2 3
Scared 0 1 2 3
Indigestion 0 1 2 3
Faint/Lightheaded 0 1 2 3
Face Flushed 0 1 2 3
Hot/Cold Sweats 0 1 2 3

Name:
Email:

By submitting this form, you agree that we may use the data you provide to contact you with information related to your request.