PROMIS Parent "*" indicates required fields PROMIS Parent Proxy 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. My child felt nervous* Never Almost Never Sometimes Often Almost Always 2. My child felt scared* Never Almost Never Sometimes Often Almost Always 3. My child felt worried* Never Almost Never Sometimes Often Almost Always 4. My child felt like something awful might happen* Never Almost Never Sometimes Often Almost Always 5. My child worried when he/she was at home* Never Almost Never Sometimes Often Almost Always 6. My child got scared really easy* Never Almost Never Sometimes Often Almost Always 7. My child worried about what could happen to him/her* Never Almost Never Sometimes Often Almost Always 8. My child worried when he/she went to bed at night* Never Almost Never Sometimes Often Almost Always
