Anxiety Assessment Tool For Adolesents – Sri Healthcare-Research International (SHRI)

Sri Healthcare-Research International (SHRI)

8811046985
7003549210

drsanghamitrasausengupta@gmail.com shrihealthcareteam@gmail.com

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Anxiety Assessment Tool

FOR ADOLESENTS

Please fill in your details below before taking the scale… This would help us get back to you!

Personal Details

Name: *
Contact Number: *
Alternate Contact Number:
Email: *

Below is a list of statements describing how you might have felt or acted in the past 2 weeks. Kindly tick the Column which suits best describes your experience in the past two weeks. The meaning of each score:

1 (NEVER)–	You almost never experience it
2 (SOMETIMES)–	The statement is true for you, but not always
3 (ALWAYS)–	The statement is almost always true for you

There are no right or wrong answers, and is completely relative to what you have experienced, which may be different for each individual.

I get frightened easily 123 I worry that awful things might happen with me 123 I worry that other people will not like me 123 I get nervous when I am with unknown people 123 My heart beats fast when I am scared 123 I feel scared to be left alone in the house 123 When I am fearful, I feel like I will choke 123 I think too much about the unpleasant experiences I have had 123 I don’t prefer to talk to people I don’t know 123 In class even when though I know the correct answer, I don’t respond due to the fear of being wrong 123 I make a lot of mistakes in exams even after knowing the answers because I became extremely nervous 123 I feel nervous when I have to go to a social occasion 123 In exams ,my heart beats faster 123 I am scared of heights or lifts 123 When I am in an exam, my hands sweat heavily 123

[calculate_button “Calculate”] Result: Press SUBMIT to know what the score means…

Phone: 8811046985 / 9748441834 / 7003549210
Mail: drsanghamitrasausengupta@gmail.com / shrihealthcareteam@gmail.com

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