Anxiety Questionnaire/Scorer
Knowledge is power - this form is intended to arm you with more insight about how you tick and what makes you, you! 
  • Your information will not be shared with another entity. 
  • The score presented from this questionnaire is not a medical diagnoses. 
  • Please contact us or call 419.285.6655 for an assessment to obtain an official diagnoses. 
  • Symptom medication is available. 
Anxiety Scoring to meet DSM-V criteria for General Anxiety Disorder symptoms (not official diagnoses)      Score of ≥6 = Anxiety indicated.
Name *
Phone Number *
We will text you only once regarding your score - providing options to manage your symptoms. 
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