February 18, 2020 Comment: 0 Quizzes Step 1 of 3 - Part 1 33% What is your age?*Please enter a value between 16 and 150.Your Gender*FemaleMaleOtherThink back about how you’ve felt over the past month. Please choose how often you’ve experienced each of the following anxiety symptoms during that time:1. Pounding heartUsuallyOftenSometimesRarelyNever2. SweatingUsuallyOftenSometimesRarelyNever3. Trembling or shakingUsuallyOftenSometimesRarelyNever4. Shortness of breathUsuallyOftenSometimesRarelyNever5. Afraid or scaredUsuallyOftenSometimesRarelyNever6. Chest pain or discomfortUsuallyOftenSometimesRarelyNever7. Nausea or abdominal distressUsuallyOftenSometimesRarelyNever8. Feeling dizzy or unsteadyUsuallyOftenSometimesRarelyNever9. Fear of losing control or going crazyUsuallyOftenSometimesRarelyNever10. Numbness or tingling sensationsUsuallyOftenSometimesRarelyNever 11. Chills or hot flashesUsuallyOftenSometimesRarelyNever12. Fear of dyingUsuallyOftenSometimesRarelyNever13. Constant or persistent worryUsuallyOftenSometimesRarelyNever14. Feeling of chokingUsuallyOftenSometimesRarelyNever15. Unable to relaxUsuallyOftenSometimesRarelyNever16. Feeling of being unrealUsuallyOftenSometimesRarelyNever17. NervousUsuallyOftenSometimesRarelyNever18. Feeling shaky or wobblyUsuallyOftenSometimesRarelyNever19. Irritable or difficulty sleepingUsuallyOftenSometimesRarelyNever20. Trembling handsUsuallyOftenSometimesRarelyNever21, Avoid situations because of anxietyUsuallyOftenSometimesRarelyNever22. Feeling lightheaded or faintUsuallyOftenSometimesRarelyNever Test ResultPlease enter your personal information to receive the test results.Your Name* First Last Your Email* This iframe contains the logic required to handle Ajax powered Gravity Forms.