Anxiety Screening for Children (6 - 17) - Completed by Parent/Guardian

Please check the appropriate box:

During the past 2 weeks
My Child said that he/she felt like something awful might happen
Said that he or she felt scared
Said that he or she felt worried
Said that he or she felt nervous
I saw that my child got scared really easy
My child was afraid of going to school
Has either been eating too much or not enough
Has wanted to be alone and by him or herself
Has not cared about anything
Has felt alone and feels no one understands him or her
Has felt like a failure and that he/she can’t do anything right

Disclaimer

This screening tool is not to be used as a substitute for medical or mental health advice, diagnosis, or treatment of any health condition or problem. This screening is simply provided as an educational tool. Users should not rely on information provided by this tool for medical or mental health decision making, and should direct all questions regarding medical or mental health matters to their physician or other health care provider.  Use of the screening tool does not create an express or implied doctor-patient relationship. Kazmo Brain Center does not record specific user information and cannot contact users of the assessment.  Users should consult with a physician or other mental health professional prior to making any decision, or undertaking any action or not undertaking any action related to any health care problem or issue that users may have at any time, now or in the future. In using the screening you agree that neither Kazmo Brain Center nor any other party is or will be liable or otherwise responsible for any decision made or any action taken or any action not taken due to your use of any information presented in the screening.

Kazmo Brain Center makes no warranties, express or implied, regarding the accuracy, completeness, timeliness, comparative or controversial nature, or usefulness of any information contained or referenced in the assessment. Kazmo Brain Center does not assume any risk whatsoever for use of the assessment or the information contained therein.