Panic
Assessment

Therapeutic Support Tools

A structured record of panic attack symptoms, triggers, and their
impact on daily functioning — completed after an episode
while details are still fresh.

Where This Tool Helps

Panic attacks are disorienting by design. The nervous system produces a cascade of physical and cognitive symptoms in rapid succession, and in the aftermath, most people want to move past the experience rather than examine it. That instinct is understandable, but it works against recovery.

What gets recorded right after a panic attack is more accurate than what gets recalled days later. This assessment is designed to be completed as soon as possible after an episode, while the details are still accessible. The physical sensations, the specific thoughts, the context — all of it fades faster than it feels like it will in the moment.

The information gathered here serves several purposes. It creates an accurate symptom record that supports any therapeutic or medical work you are doing. Over multiple episodes, it can reveal patterns — particular triggers, times of day, or circumstances that appear consistently. And it helps distinguish between different types of distress, since not all acute anxiety events present the same way.

The behavior change question at the end is where avoidance tends to become visible. What people stop doing, or start planning around, after panic attacks is often where the largest disruption to functioning lives. Naming it clearly is the first step to addressing it.

Completing this tool is not the same as processing the experience. It is documentation — a way to bring accuracy to something the mind tends to either catastrophize or minimize in retrospect.

How to Use This Assessment

Complete this as soon as possible after a panic attack — within a few hours if you can. The closer to the event, the more accurate your responses will be.

  1. Start with the Before the Attack section. Note what you were thinking, feeling, and doing in the moments before symptoms started — even if nothing seemed unusual.
  2. Go through the symptom checklist and mark every symptom that occurred during this episode.
  3. Rate your worry level about future attacks on the 1–10 scale.
  4. Rate your discomfort level during this specific attack on the 1–10 scale.
  5. Answer the behavior change question. Be specific about any changes you have made or are planning.

Panic Assessment

Before the Panic Attack

What were you thinking in the moments before symptoms began?

What were you feeling emotionally?

What were you doing?

Symptoms During This Attack

Check all that applied

Pounding or racing heart
Difficulty breathing
Sweating
Sense of terror, doom, or fear of death
Nausea
Feeling dizzy, lightheaded, or faint
Fear of going crazy or losing control
Feeling detached from reality
Chest pain or tightness
Chills or waves of heat
Choking sensation
Numbness or tingling
Trembling or shaking
Ratings

How worried are you right now about having another attack?

1 = Not worried at all    10 = Extremely worried

Not worried at all
1
2
3
4
5
6
7
8
9
10
Extremely worried

How much discomfort did you experience during this attack?

1 = Minimal discomfort    10 = Extreme discomfort

Minimal discomfort
1
2
3
4
5
6
7
8
9
10
Extreme discomfort

Panic Assessment (continued)

Behavior Change

Have you changed any behavior because of your panic attacks?

Yes
No

If yes, describe what you have stopped doing, started avoiding, or changed:

Notes — Anything else relevant about this episode

Tandem Coaching Partners

Credentialed coaches with real-world leadership experience,
partnering with executives and organizations
to unlock sustainable growth.

Consultation

tandemcoach.co/
contact-us

Email

info@tandemcoach.co

Phone

855 51 COACH

Challenge your thinking.
Discover your capabilities.
Act on them.

Dallas, TX  |  Houston, TX  |  Worldwide Virtual