Online Claustrophobia Questionnaire

An online claustrophobia questionnaire is a set of questions which are conducted in the form of a test which is conducted online to test a person’s claustrophobia levels. Such questionnaires are helpful in judging or analysing a person’s inner fears and suggesting ways to help them.

Sample online claustrophobia questionnaire:

Name of applicant: _____________

Age of applicant: ________________

Address of applicant: _____________

Email address: ______________

Contac number: ______________

The following are your questions:

Q1. Do you feel anxious when you are inside confined spaces or places?

a)   Yes

b)   No

Q2. How anxious do you feel when you think about confined spaces?

a)   Extremely anxious

b)   Very anxious

c)   Somewhat anxious

d)   Not anxious

Q3. How what you rate your claustrophobia problem on a scale of 10?

Q4. How bad are your symptoms of claustrophobia?

a)   The symptoms are pretty bad and I have to use drugs to help myself

b)   The symptoms are not good but I don’t use drugs or medicines

c)   The symptoms are uncomfortable and I have used drugs in the past

d)   The symptoms are uncomfortable but I don’t use drugs or medicines.

e)   I don’t really get very uncomfortable.

Q5. Do you dramatized or think of situations which are related to confined spaces?

a)   Yes, all the time

b)   Yes, sometimes

c)   Not very much

d)   Not at all

Q6. Does this problem of yours prove to be of a difficulty when it comes to family and friends?

Q7. Do you think this that your problem is increasing or decreasing with time?

Category: Online Questionnaire

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