Request edit access
Exposure Tracking Log
Name
Date and time
MM
/
DD
/
YYYY
Description of exposure
Pre Exposure Anxiety Level
Minimal
Extreme
Clear selection
What sensations and thoughts are you noticing?
Anxiety Level: 1 minute into exposure
Clear selection
What sensations and thoughts are you noticing?
Anxiety Level: 5 minutes into exposure
Clear selection
Anxiety Level: 10 minutes into exposure
Clear selection
What sensations and thoughts are you noticing?
Any key takeaways or lessons learned from this exercise?
Submit
Never submit passwords through Google Forms.
This form was created inside of Light on Anxiety. Report Abuse