Anxiety

Help us understand the severity of your anxiety

How are you feeling today?

Over the past 2 weeks, how often have you felt nervous, anxious, or on edge?

Over the past 2 weeks, how often have you been unable to stop or control feelings of worry?

Over the past 2 weeks, how often have you worried too much about different things?

Over the past 2 weeks, how often have you had trouble relaxing?

Over the past 2 weeks, how often have you been so restless that it is hard to sit still?

Over the past 2 weeks, how often have you become easily annoyed or irritated?

Over the past 2 weeks, how often have you felt afraid, as if something awful might happen?

Over the past 2 weeks, how difficult has it been for you to do your work, take care of things at home, or get along with other people?

When did your symptoms first begin?

Let's find the right treatment for you

Have you ever used any of the following mental health medications in the past?

If you have tried treatments in the past, what was your treatment, was it successful, and are you still using it?

Is there anything else related to treatment that you'd like to ask or discuss with your medical provider?

Do you have a preferred treatment?

Would you like to share anything else with your provider through an upload?