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BAI - Beck Anxiety Inventory

Heidrich Psychological Evaluations Center and Psychotherapy
270 26th St. Suite 201. Santa Monica, CA. 90405
5743 Corsa Ave. Ste 125. Westlake Village, CA. 91360
Brenda Heidrich | Ph.D Lic# Psy 29105 | Phone: 310-748-8393

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Personal Information

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Name(Required)
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Evaluation BAI

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 that symptom during the past month, including today, by circling the number in the corresponding space in the column next to each symptom.
Numbness or tingling(Required)
Feeling hot(Required)
Wobbliness in legs(Required)
Unable to relax(Required)
Fear of worst happening(Required)
Dizzy or lightheaded(Required)
Heart pounding/racing(Required)
Hot/cold sweats(Required)
Unsteady(Required)
Terrified or afraid(Required)
Nervous(Required)
Feeling of choking(Required)
Hands trembling(Required)
Shaky / unsteady(Required)
Fear of losing control(Required)
Difficulty in breathing(Required)
Fear of dying(Required)
Indigestion(Required)
Scared(Required)
Faint / lightheaded(Required)
Face flushed(Required)
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Contact

Call us to schedule an appointment
Dr. Goodman: +1 -818-917-4524 
Dr. Heidrich: +1-310-748-8393 ,
or
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as soon as possible.