Anxiety Patient Name *Phone Number *Email Address *1. Feeling nervous, anxious, or on edge *2. Not being able to stop or control worrying *3. Worrying too much about different things *4. Trouble relaxing *5. Being so restless that it is hard to sit still *6. Becoming easily annoyed or irritable *7. Feeling afraid, as if something awful might happen *If you checked any problems, how difficult have they made it for you to do your work, take care of things at home, or get along with other people?Not difficult at allSomewhat difficultVery difficultExtremely difficult Submit
