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* 1. Being Criticized Scares Me

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* 2. I Worry About What Other People Think Of Me

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* 3. Are You A Man Or A Woman?

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* 4. What Is Your #1 Biggest Challenge With Social Anxiety Right Now? (Write as much detail as possible)

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* 5. I Avoid Speaking For Fear Of Embarrassment

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* 6. What Is Your #1 Challenge With Conversations Right Now? (Provide As Much Detail As Possible)

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* 7. I Struggle Most With

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* 8. What Is Your Email?

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* 9. What is your Phone Number? (Optional)
(I occasionally connect with people to find out more about their situation)

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