PROMIS Child "*" indicates required fields PROMIS Pediatric Item Bank v2.0 – Anxiety – Short Form 8aChild's Name* First Last Child's Date of Birth* MM slash DD slash YYYY Parent/Guardian's name* First Last Today's Date* MM slash DD slash YYYY In the past 7 days…1. I felt like something awful might happen.* Never Almost Never Sometimes Often Almost Always 2. I felt nervous.* Never Almost Never Sometimes Often Almost Always 3. I felt scared.* Never Almost Never Sometimes Often Almost Always 4. I felt worried* Never Almost Never Sometimes Often Almost Always 5. I worried when I was at home* Never Almost Never Sometimes Often Almost Always 6. I got scared really easy* Never Almost Never Sometimes Often Almost Always 7. I worried about what could happen to me* Never Almost Never Sometimes Often Almost Always 8. I worried when I went to bed at night* Never Almost Never Sometimes Often Almost Always
