Anxiety Assessment form Anxiety Assessment Form1. Feeling nervous, anxious, or on edge Not at all Several days More than half the days Nearly every day2. Not being able to stop or control worrying Not at all Several days More than half the days Nearly every day3. Worrying too much about different things Not at all Several days More than half the days Nearly every day4. Trouble relaxing Not at all Several days More than half the days Nearly every day5. Being so restless that it is hard to sit still Not at all Several days More than half the days Nearly every day6. Become easily annoyed or irritable Not at all Several days More than half the days Nearly every day7. Feeling afraid as if something awful might happen Not at all Several days More than half the days Nearly every dayPlease repeat your name and last nameSubmit Form