Request edit access
Weightless Warriors
Short PTSD Rating Interview (SPRINT)
First Name *
Your answer
Last Name *
Your answer
Float Center Name *
Your answer
City of Residence *
Your answer
Date *
MM
/
DD
/
YYYY
How much have you been bothered by· unwanted memories, nightmares, or reminders of the event(s) that led to your PTSD? *
Not at all
Very much
How much effort have you made to avoid thinking or talking about the event, or doing things which remind you of what happened? *
None
Very much
To what extent have you lost enjoyment for things, kept your distance from people, or found it difficult to experience feelings? *
Not at all
Very much
How much have you been bothered by poor sleep, poor concentration, jumpiness, irritability, or feeling watchful around you? *
Not at all
Very much
How much have you been bothered by pain, aches, or tiredness? *
Not at all
Very much
How much would you get upset when stressful events or setbacks happen to you? *
Not at all
Very much
How much have the above symptoms interfered with your ability to work or carry out daily activities? *
Not at all
Very much
How much have the above symptoms interfered with your relationships with family or friends? *
Not at all
Very much
Float Effectiveness Assessment
Please only answer the questions below if you have floated before.
How much better do you feel since you started floating? (as a percentage)
How much have the above symptoms improved since you started floating?
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms