BECK ANXIETY INVENTORY

This scale is a self-report measure of anxiety.

Below is a list of common symptoms of anxiety. Please carefully read each item in the list. Indicate how much you have been bothered by the symptom during the past month, including today, by checking the numbe rin the corresponding space in the column next to each symptom.

Who will be participating?

Adult Adult and Children

Parent / Guardian Information

First Name *

Last Name *

Your Date of Birth *

Phone *

Email Address *

Confirm Email Address *

Address *

Address Line 2

City *

State *

Zip *

Please enter participants' full names:

Add Another Name

Join the mailing list

Sign Here

I certify that my answers are true and complete to the best of my knowledge. I authorize a background check through National Center for Safety Initiatives