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Activities
Mental Health Program
Trauma
Anxiety
Depression
ADHD
Bipolar
Addiction Program
Alcohol
Benzodiazepines
Opiates
Cocaine
Amphetamine
Marijuana
Heroin
Hallucinogens
Barbiturates
Adderall
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Verify Insurance
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Anxiety Quiz
At Maple Mountain Wellness
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Anxiety Quiz
Step
1
of
8
12%
Hidden
1
1. Feeling nervous, anxious, or on edge. Over the last 2 weeks, how often have you been bothered by the following problems?
(Required)
Not At All
Several Days
Over Half The Days
Nearly Every Day
Hidden
2
2. Not being able to stop or control worrying. Over the last 2 weeks, how often have you been bothered by the following problems?
(Required)
Not At All
Several Days
Over Half The Days
Nearly Every Day
Hidden
3
3. Worrying too much about different things. Over the last 2 weeks, how often have you been bothered by the following problems?
(Required)
Not At All
Several Days
Over Half The Days
Nearly Every Day
Hidden
4
4. Trouble relaxing. Over the last 2 weeks, how often have you been bothered by the following problems?
(Required)
Not At All
Several Days
Over Half The Days
Nearly Every Day
Hidden
5
5. Being so restless that it's hard to sit still. Over the last 2 weeks, how often have you been bothered by the following problems?
(Required)
Not At All
Several Days
Over Half The Days
Nearly Every Day
Hidden
6
6. Becoming easily annoyed or irritable. Over the last 2 weeks, how often have you been bothered by the following problems?
(Required)
Not At All
Several Days
Over Half The Days
Nearly Every Day
Hidden
7
7. Feeling afraid as if something awful might happen. Over the last 2 weeks, how often have you been bothered by the following problems?
(Required)
Not At All
Several Days
Over Half The Days
Nearly Every Day
Name
(Required)
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Email
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Phone
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