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Please answer these final questions about how you’re feeling right now.


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
Please select a response


✓ Thank you!

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