I understand that Belisama’s Retreat need to store my personal information in order to ensure my safety and to offer a personalised service
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Feeling nervous, anxious, or on edge
Not being able to stop or control worrying
Worrying too much about different things
Being so restless that it's hard to sit still
Becoming easily annoyed or irritable
Feeling afraid as if something awful might happen
If you checked off any problems, how difficult have these made it for you to do your work, take care of things at home, or get along with other people?