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Please answer all questions based on how you are feeling NOW, at this moment.
Please read carefully:

A number of statements are given below. Read each statement and then select the response that indicates how you feel now, at this moment. There are no right or wrong answers. Do not spend too much time on any one statement, but give the answer which seems to describe your present feelings best.
Higher = more calm 1 = Not at all    2 = Somewhat    3 = Moderately so    4 = Very much so
1
Not at all
2
3
4
Very much so
Please select a response
Higher = more tense 1 = Not at all    2 = Somewhat    3 = Moderately so    4 = Very much so
1
Not at all
2
3
4
Very much so
Please select a response
Higher = more upset 1 = Not at all    2 = Somewhat    3 = Moderately so    4 = Very much so
1
Not at all
2
3
4
Very much so
Please select a response
Higher = more relaxed 1 = Not at all    2 = Somewhat    3 = Moderately so    4 = Very much so
1
Not at all
2
3
4
Very much so
Please select a response
Higher = more content 1 = Not at all    2 = Somewhat    3 = Moderately so    4 = Very much so
1
Not at all
2
3
4
Very much so
Please select a response
Higher = more worried 1 = Not at all    2 = Somewhat    3 = Moderately so    4 = Very much so
1
Not at all
2
3
4
Very much so
Please select a response
0 = Not anxious at all    10 = Extremely anxious
0
Not at all
1
2
3
4
5
6
7
8
9
10
Extremely anxious
Please select a response
Please select an option
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