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TalkDoctors Anxiety Inventory (brief version)*

Please print this page and follow the instructions below.

Instructions: Place a check in the box to the right of each symptom to indicate how much this type of feeling has been bothering you in the past several days. Then total your score, refer to the scoring key below, and call us toll free at 1-877-368-6000 or E-mail if you score 3 or above.

	0 - not at all	1 - somewhat	2 - moderately	3 - a lot
1. Feeling anxious, nervous, worried, panicky or afraid
2. Feeling tense, restless or unable to relax
3. Feeling stressed, uptight or on edge
4. Frightening thoughts, fantasies or daydreams
5. Physical feelings of stress, such as tight muscles, shortness of breath or a racing heart

Scoring Key for the Anxiety Inventory

Total Score	Degree of Anxiety	Action
0	no anxiety	no treatment is needed
1 - 2	minimal anxiety	no treatment is needed
3 - 5	borderline to mild anxiety	treatment can be helpful
6 -10	moderate anxiety	treatment is almost always needed
11 - 15	severe anxiety or panic	treatment is almost always needed

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