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Hi, 
all your answers in this questionnaire will remain anonymous you do not have to answer any questions you don't want to: you have the right to withdraw at any time. 
 
 
 
 
Where would you feel most confident socially?
 
Party
 
Library
 
School
 
Meal
 
Park
 
All
 
None
 
Other
 
 
 
 
What is in your opinion most intimidating? (public speech at school or introducing yourself at a party where you do not know anyone. ) 
 
Speech
 
Party
 
Both
 
Neither
 
 
 
Which group size do you feel most confident in? 
 
None
 
1-3
 
4-6
 
7+
 
 
 
What gender do you feel most confident speaking to?
 
Female
 
Male
 
Both
 
Neither
 
 
 
what gender are you?
 
Female
 
Male
 
 
Do you fear that you will end up doing something embarrassing or humiliating in any social situation- for instance: blushing, sweating, or appearing incompetent (rate this on a scale of 1 to 10 - ten being very fearful, 1 being not fearful at all.)
1 2 3 4 5 6 7 8 9 10
Rating
 
 
 
Do you fear talking to authority figures? 
 
Always
 
Mostly
 
Sometimes
 
Never
 
 
 
Would you describe your parents as any of these?
 
Over-protective
 
Not affectionate enough
 
Constantly criticising
 
Over emphasising importance of manners
 
exaggerating danger of strangers
 
None
 
 
 
Do you constantly feel as though you are being negatively judged in any social situation?
 
Always
 
Mostly
 
Sometimes
 
Never
 
 
 
Do you fear participating in any classroom activities?(E.G. group work/presentation.)
 
Always
 
Mostly
 
Sometimes
 
Never
 
Thank you for completing our questionnaire investigating social phobias: you have the option to view the results after we have completed. 
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