Anxiety & Stress Survey

Question Title

1. In the past 4 weeks, about how often did you feel tired out for no good reason? (Required.)

Always

Usually

Sometimes

Rarely

Never

Question Title

2. In the past 4 weeks, about how often did you feel nervous? (Required.)

Always

Usually

Sometimes

Rarely

Never

Question Title

3. In the past 4 weeks, about how often did you feel so nervous that nothing could calm you down? (Required.)

A great deal

A lot

A moderate amount

A little

None at all

Question Title

4. In the past 4 weeks, about how often did you feel hopeless? (Required.)

Always

Usually

Sometimes

Rarely

Never

Question Title

5. In the past 4 weeks, about how often did you feel restless or fidgety? (Required.)

Always

Usually

Sometimes

Rarely

Never

Question Title

6. In the past 4 weeks, about how often did you feel so restless you could not sit still? (Required.)

Always

Usually

Sometimes

Rarely

Never

Question Title

7. In the past 4 weeks, about how often did you feel depressed? (Required.)

Always

Usually

Sometimes

Rarely

Never

Question Title

8. In the past 4 weeks, about how often did you feel that everything was an effort? (Required.)

Always

Usually

Sometimes

Rarely

Never

Question Title

9. In the past 4 weeks, about how often did you feel so sad that nothing could cheer you up? (Required.)

Always

Usually

Sometimes

Rarely

Never

Question Title

10. In the past 4 weeks, about how often did you feel worthless? (Required.)

A great deal

A lot

A moderate amount

A little

None at all

Anxiety & Stress Survey

Question Title

* 1. In the past 4 weeks, about how often did you feel tired out for no good reason? (Required.)

Question Title

* 2. In the past 4 weeks, about how often did you feel nervous? (Required.)

Question Title

* 3. In the past 4 weeks, about how often did you feel so nervous that nothing could calm you down? (Required.)

Question Title

* 4. In the past 4 weeks, about how often did you feel hopeless? (Required.)

Question Title

* 5. In the past 4 weeks, about how often did you feel restless or fidgety? (Required.)

Question Title

* 6. In the past 4 weeks, about how often did you feel so restless you could not sit still? (Required.)

Question Title

* 7. In the past 4 weeks, about how often did you feel depressed? (Required.)

Question Title

* 8. In the past 4 weeks, about how often did you feel that everything was an effort? (Required.)

Question Title

* 9. In the past 4 weeks, about how often did you feel so sad that nothing could cheer you up? (Required.)

Question Title

* 10. In the past 4 weeks, about how often did you feel worthless? (Required.)

1. In the past 4 weeks, about how often did you feel tired out for no good reason? (Required.)

2. In the past 4 weeks, about how often did you feel nervous? (Required.)

3. In the past 4 weeks, about how often did you feel so nervous that nothing could calm you down? (Required.)

4. In the past 4 weeks, about how often did you feel hopeless? (Required.)

5. In the past 4 weeks, about how often did you feel restless or fidgety? (Required.)

6. In the past 4 weeks, about how often did you feel so restless you could not sit still? (Required.)

7. In the past 4 weeks, about how often did you feel depressed? (Required.)

8. In the past 4 weeks, about how often did you feel that everything was an effort? (Required.)

9. In the past 4 weeks, about how often did you feel so sad that nothing could cheer you up? (Required.)

10. In the past 4 weeks, about how often did you feel worthless? (Required.)