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BAI Form


Below is list of common symptoms of anxiety. Please carefully read each item in the list. Indicate how much you have been bothered by each symptom during the PAST WEEK, INCLUDING TODAY, by selecting the corresponding space in the column next to each symptom.

The rating scale is as follows:

  • 0   NOT AT ALL
  • 1   MILDLY (It did not bother me much)
  • 2   MODERATELY (It was very unpleasant, but I could stand it) 
  • 3   SEVERLY (I could barely stand it)