3 minutes to complete
The Social Anxiety Survey is open to all individuals who experience social anxiety.
Full Name
What is your age?
What is your gender?
Phone Number
Do you have any fears or worries about social situations?
Do you worry about what others think of you in social situations?
Do you avoid social situations because you are afraid of embarrassing yourself?
Do you feel like you have to put on a “mask” or act differently in social situations?
Do you get anxious when meeting new people?
Do you find yourself withdrawing from social situations?
Do you get tongue-tied or have difficulty talking in social situations?
Do you get butterflies in your stomach or feel nauseous in social situations?
Do you have trouble sleeping before a social event?
Do you get sweaty or have a racing heart in social situations?
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