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Tinnitus and hyperacusis therapy specialist unit
Social Anxiety
Please indicate how much the following problems have bothered you during the past week. Mark only one box for each problem, and be sure to answer all items.
Name of the patient:
Email address
Questionnaire
Not at all
(0)
A little bit
(1)
Somewhat
(2)
Very much
(3)
Extremely
(4)
1. Fear of embarrassment causes me to avoid doing things or speaking to people
2. I avoid activities in which I am the centre of attention
3. Being embarrassed or looking stupid is among my worst fears
Submit
For Hearing Healthcare Professionals
