Anxiety Survey

Hi, thanks for checking out our questionnaire. If you've been asking yourself "is this a panic attack?" at time or worry impacts your day to day life, you may have an anxiety disorder. While we still recommend you seek the advice of a medical professional, we've created this brief questionnaire to help you find out if you have symptoms that may be signs of an anxiety disorder.

Please fill in your name and email in the boxes below, then fill out the survey below.

I get sudden chills or hot flushes, cold sweats or sudden sweating without physical exertion/stimuli(heat, humidity etc).
My heart pounds rapidly or heavily.
I get trembling or shaking.
I suffer from shortness of breath without physical exertion.
I feel afraid or scared, whether for seemingly no reason or a specific persistent thought.
I get chest pain or discomfort.
I get nausea or discomfort in my abdominal area. Whether for no apparent reason or from specific triggers.
I feel dizzy or unsteady.
I have a fear of losing control or going crazy whether over a specific thought or for a general reason.
I get tingling feelings or feelings of numbness either in my extremities or my entire body. This may be due to a specific recurring thought or for no apparent reason.
I have constant or persistent worry whether in general or over specific thoughts.
I get feelings of choking without anything physically asphyxiating me.
I get feelings of either myself or the situation being unreal.
I get feelings of lightheadedness or feel faint.
I avoid situations to avoid aforementioned symptoms.

Name

Email