Generalised Anxiety Rating Form Spam protection, skip this field Full Name Over the last 2 weeks, how often have you been bothered by the following problems? (optional) Feeling nervous, anxious, or on edge Not at all sure Several Days Over half the days Nearly every day Not being able to stop or control worrying Not at all sure Several days Over half the days Nearly every day Worrying too much about different things Not at all sure Several days Over half the days Nearly every day Trouble relaxing Not at all sure Several days Over half the days Nearly every day Being so restless that its hard to sit still Not at all sure Several days Over half the days Nearly every day Becoming easily annoyed or irritable Not at all sure Several days Over half the days Nearly every day Feeling afraid as if something awful might happen Not at all sure Several days Over half the days Nearly every day How difficult have the above issues made it for you to do your work? Not difficult at all Somewhat difficult Very difficult Extremely difficult How difficult have the above issues made it for you to take care of things at home? Not difficult at all Somewhat difficult Very difficult Extremely difficult How difficult have the above issues made it for you to get along with other people? Not difficult at all Somewhat difficult Very difficult Extremely difficult
