Fillable Anxiety Symptoms Questionnaire (Wave Therapist)

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Anxiety Symptoms Questionnaire (Wave Therapist)

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Beck Anxiety
Inventory
Below is a list of common symptoms of anxiety. Please carefully read each item in the list.
Indicate how much you
have been bothered by that symptom during the past month, including
today, by circling the number in the
corresponding space in the column next to each symptom.
Not At All
0
Mildly but it
didn’t bother me
much. 1
Moderately - it
wasn’t pleasant at
times 2
Severely – it
bothered me
a lot
3
Numbness or tingling
Feeling hot
Wobbliness in legs
Unable to relax
Fear of worst
happening
Dizzy or lightheaded
Heart pounding/racing
Unsteady
Terrified or afraid
Nervous
Feeling of choking
Hands trembling
Shaky / unsteady
Fear of losing control
Difficulty in breathing
Fear of dying
Scared
Indigestion
Faint / lightheaded
Face flushed
Hot/cold sweats
Column Sum
Scoring - Sum each column. Then sum the column totals to achieve a grand score.
Write grand score here _________ .
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Anxiety Symptoms Questionnaire (Wave Therapist)

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Completed 11 September 2020

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