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Over the last 2 weeks, how often have you been bothered by the following problems?

Please note, all fields are required.

1. Feeling nervous, anxious, or on edge

Not at all Several days More than half days Nearly every day None

2. Not being able to stop or control worrying

Not at all Several days More than half days Nearly every day None

3. Worrying too much about different things

Not at all Several days More than half days Nearly every day None

4. Trouble relaxing

Not at all Several days More than half days Nearly every day None

5. Being so restless that it is hard to sit still

Not at all Several days More than half days Nearly every day None

6. Becoming easily annoyed or irritable

Not at all Several days More than half days Nearly every day None

7. Feeling afraid, as if something awful might happen

Not at all Several days More than half days Nearly every day None

8. In the last three months, have you often worried a lot before you were going to play a sport or game or do some other activity?

Not at all Several days More than half days Nearly every day None

9. In the last three months, have you had a lot of headaches?

Not at all Several days More than half days3 Nearly every day None

10. Are you the kind of person who is often very tense or who finds it very hard to relax?

Not at all Sometimes Most of the times Usually None

Time’s up

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We are NOT an emergency mental health treatment clinic. If you are experiencing a mental health emergency you can call 9-8-8, and talk with someone now. Also, see our Crisis Resources page.