First Name *

Last Name *

Email *

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PTSD Self Test Part 1/3

3. Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)? *

5. Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)? *

7. Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)? *

9. Having strong negative beliefs about yourself, other people, or the world (for example, having thoughts such as: I am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous)? *

How would you classify your trauma? *

History of Traumatic Incident(s)

Please provide a thorough history describing the traumatic event or series of events that caused your symptoms of PTSD: *

I certify that the history provided here is true and accurate to the best of my knowledge *

Yes

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