Social Anxiety Survey
My goal is to make social anxiety not only manageable, but perhaps completely avoidable.

Your responses to this survey will be key to helping me address your most pressing concerns and pain points regarding any social fears or phobias you experience.

Thank you for your time! This will only take a few minutes.

Do you currently experience social anxiety?
How often do you experience it?
Where and when do you experience it most often?
Do you ever experience it in minor ways at other times?
Your answer
Do you know you're going to feel anxious before your anxiety starts?
When you're about to experience anxiety, is there anything you visualize in your head right before it happens? Do you say anything to yourself?
Your answer
Are you aware of any physical symptoms you have when you're about to experience anxiety? Describe them below.
Your answer
When you're in the middle of your anxiety, what beliefs do you have about the people around you in that moment? (i.e. "I believe they don't like me")
Your answer
Are there any questions you'd like to have answered about anxiety or social anxiety in particular?
Your answer
What have you tried to do to help alleviate your anxiety?
Have you found anything that helps to decrease anxiety for you?
Your answer
On a scale of 1 to 10, 10 being the most anxious, how would you rate your social anxiety?
Instead of anxious, what would you rather feel instead?
Your answer
Are there any other comments you'd like to make, or questions you'd like to ask about social anxiety?
Your answer
Thank you for filling out this survey! If you'd like to be notified when The S.A.F.E. Empowerment System is released, leave your email below. You can also pre-order for 30% off the full price using the button below this form
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.