Child's Name(Required)
Mom's Name(Required)
1. I’ve been able to see the funny side of things...(Required)
2. I have looked forward with enjoyment to things...(Required)
3. I’ve blamed myself unnecessarily when things went wrong...(Required)
4. I’ve been anxious and worried for no good reason...(Required)
5. I’ve felt scared or panicky for no good reason:(Required)
6. Things have been getting on top of me…(Required)
7. I’ve been so unhappy that I have difficulty sleeping...(Required)
8. I’ve felt sad or miserable...(Required)
9. I’ve been so unhappy that I have been crying...(Required)
10. The thought of harming myself has occurred to me...(Required)