1 – Not at all
2 – Several days
3 – More than half the days
4 – Nearly every day
¹
1
2
3
4
1
Feeling nervous, anxious or on edge?
2
Not being able to stop or control worrying?
3
Worrying too much about different things?
4
Trouble relaxing?
5
Being so restless that it is hard to sit still?
6
Becoming easily annoyed or irritable?
7
Feeling afraid as if something awful might happen?
The presented answer sheet is not an original form and is not intended for printing or use as a handout.
The answer numbers are used only to label response columns. They are NOT scores and should not be used for calculating results.