Tinnitus and hyperacusis therapy specialist unit

Name: Hashir International
Address: 54 Quarry Street, Guildford, GU1 3UA, GB
Telephone: 01483 255605
Price range: £

PSWQ

Tick the item that best describes how typical or characteristic each item is of you.

Name of the patient:

Your Email Address:

Please type the email address that this form needs to be sent to. This is often the email address of your clinician who asked you to complete this form.

For each question please select one number based on how you are feeling now.

Questions (Use “✓” to indicate your answer)	Not at all typical	–	Somewhat typical	–	Very typical
1. My worries overwhelm me.	1	2	3	4	5
2. Many situations make me worry.	1	2	3	4	5
3. I know I should not worry about things, but I just cannot help it.	1	2	3	4	5
4. When I am under pressure, I worry a lot.	1	2	3	4	5
5. I am always worrying about something.	1	2	3	4	5
6. As soon as I finish one task, I start to worry about everything else I must do.	1	2	3	4	5
7. I have been a worrier all my life.	1	2	3	4	5
8. I have been worrying about things.	1	2	3	4	5

For Hearing Healthcare Professionals