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Welcome To The Anxiety Freedom Today Survey.
By filling in this short anonymous survey about your anxiety you will get a FREE reduce your anxiety in 7 days or less e-book.
Anxiety Freedom Today Survey
Ok, Let's start off by telling me your name
(Required)
What type of Anxiety do you suffer from?
Social Anxiety
PTSD
Generalised Anxiety
OCD
Environmental Anxiety
Health Anxiety
Panic Disorder
Other
Unsure
How often have you been feeling anxious?
Never
Infrequently
Several Days
Most Days Of The Week
Every Day
As a child did you suffer from any of the following types of abuse?
Physical
Sexual
Psychological
Neglect
Bullying
Racial
None of the above
Other
What's the biggest challenge that anxiety has presented to you so far?
Problems with work
Problems dating
Problems sleeping
Relationship problems
Have you ever had a panic attack?
Yes
No
Have you ever sought help before for your anxiety?
Yes
No
To deal with your anxiey and feelings of loneliness have you ever done any of the following
Taken illegal drugs
Used alcohol excessively
Viewed pornography frequently
Gambled money
Eaten excessively
Smoked excessively
Been violent towards others
None of the above
Ok, Please can I have your email address, so I can send you your free course to reduce your anxiety
(Required)
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