Post Traumatic Stress Symptom Worksheet

Severity of Post traumatic Stress Symptoms—Adult

  • Date Format: MM slash DD slash YYYY
  • Instructions: People sometimes have problems after extremely stressful events or experiences. How much have you been bothered during the PAST SEVEN (7) DAYS by each of the following problems that occurred or became worse after an extremely stressful event/experience?
  • Input the value that you feel best fits you. (0) Not at all, (1) A little bit, (2) Moderately, (3) Quite a bit, (4) Extremely
  • Please enter a number from 0 to 4.
  • Please enter a number from 0 to 4.
  • Please enter a number from 0 to 4.
  • Please enter a number from 0 to 4.
  • Please enter a number from 0 to 4.
  • Please enter a number from 0 to 4.
  • Please enter a number from 0 to 4.
  • Please enter a number from 0 to 4.
  • Please enter a number from 0 to 4.
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