Everyday Anxiety & Support Check-In
Help us understand your experience and what support would be useful. Think about the past two weeks; you can skip any question. This survey is not a diagnostic tool.
How often have you felt anxious or on edge?
Choose the answer that best matches your experience.
How intense has your anxiety usually felt?
Use 0 for no anxiety and 10 for extremely intense anxiety.
Which situations have made you feel anxious?
Select all that apply. If you choose “None of these,” select it alone.
How much has anxiety affected your daily activities?
Consider things like finishing tasks, taking care of yourself, or spending time with others.
How easy has it been to settle your mind when you feel worried?
Choose the point that best reflects your experience.
What has helped you manage anxious feelings?
Select all that apply. If you choose “Not applicable,” select it alone.
Which type of support would be most useful right now?
Choose the option that would make the biggest difference for you.
What would you like us to understand about your experience?
Share any concerns or suggestions you feel comfortable sharing. Please avoid names or identifying details.
Thank you for taking a part in this survey.
