1. Telephoning in public * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
2. Participating in small groups * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
3. Eating in public places * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
4. Drinking with others in public places * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
5. Talking to people in authority * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
6. Acting, performing or giving a talk in front of an audience * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
7. Going to a party * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
8. Working while being observed * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
9. Writing while being observed * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
10. Calling someone you don’t know very well * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
11. Talking with people you don’t know very well * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
12. Meeting strangers * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
13. Urinating in a public bathroom * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
14. Entering a room when others are already seated * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
15. Being the center of attention * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
16. Speaking up at a meeting * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
17. Taking a test * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
18. Expressing a disagreement or disapproval to people you don’t know very well * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
19. Looking at people you don’t know very well in the eyes * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
20. Giving a report to a group * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
21. Trying to pick up someone * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
22. Returning goods to a store * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
23. Giving a party * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
24. Resisting a high pressure salesperson * Please rate your fear (0) None (1) Mild (2) Moderate (3) Severe
1. Telephoning in public * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
2. Participating in small groups * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
3. Eating in public places * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
4. Drinking with others in public places * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
5. Talking to people in authority * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
6. Acting, performing or giving a talk in front of an audience * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
7. Going to a party * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
8. Working while being observed * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
9. Writing while being observed * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
10. Calling someone you don’t know very well * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
11. Talking with people you don’t know very well * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
12. Meeting strangers * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
13. Urinating in a public bathroom * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
14. Entering a room when others are already seated * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
15. Being the center of attention * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
16. Speaking up at a meeting * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
17. Taking a test * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
18. Expressing a disagreement or disapproval to people you don’t know very well * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
19. Looking at people you don’t know very well in the eyes * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
20. Giving a report to a group * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
21. Trying to pick up someone * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
22. Returning goods to a store * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
23. Giving a party * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
24. Resisting a high pressure salesperson * Please rate your avoidance (0) Never (1) Occasionally (2) Often (3) Usually
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