Kill The Anxiety Questionnaire

Name *

Email *

What is your specific worry. Please list only one worry per form. *

What level of progression is this issue? *

What is the evidence that this is or might be happening? *

How are you feeling right now? (Select all that are true) *

Are there steps you can take right now or soon, that would prevent or help this issue? List them. *

If the worst case scenario happens, then what do you do next? *

Ok, and what does that mean/what after that?

And what after THAT?

After all that, is it the end of the world?

List the people that will help and support you if this does happen. *

If this happened to any degree, how would your life change? *

How does worrying about this issue help you or the object of your worry? *

Has this issue, or similar come up before? How did it turn out? How did you handle the outcome? *

What could you do in the future to avoid this issue, or avoid worrying about this issue? *

Phone

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