YES

NO

1.

Have you ever harmed anyone because of anger?

2.

Have you ever harmed anyone because of anger?

3.

Have you ever harmed a loved one when angry?.

4.

Have you ever harmed yourself when angry?

5.

Have you ever lost a job because of anger?

6.

Have you often felt guilt or remorse after getting angry?

7.

Has a significant other ever threatened to leave because of your anger?

8.

Were you ever arrested where anger was a factor?.

9.

Have you often felt unable to control your anger?

10.

Has a friend or loved one said you have a problem with anger?

11.

Has a counselor, coworker, or peer said you have a problem with anger?

12.

Does your anger push your loved ones away?

13.

Does your family avoid you when you are angry?

14.

Does your family walk on egg shells around you?

15.

Are any of your family members concerned about your anger?

16.

Do you ever get angry and then feel despair or shame about how you expressed it to others?

17.

Do you ever see fear or terror in the eyes of your kids when you get angry?

18.

Are you stuck constantly blaming and/or criticizing yourself or others?

19.

Have you ever punched a hole in the wall or damaged property when you are angry?

20.

Are you frequently grumpy, sad, or moody?

21.

Does your anger come out even when you try and control it?

22.

Do you explode so quickly that you don't even see it coming?

23.

Would you like control over your emotions?

24.

Would you like to learn to use healthy anger so people actually listen to you?

25.

Have you had alot of physical fights with other people?

26.

Have you been arrested for violence against others?

27.

Have you been, or could you be arrested because of some of your sexual behavior?

28.

Do you often feel alone and misunderstood?

29.

Does your angry behavior or angry thoughts sometimes make you feel hopeless or depressed?

30.

Have you been told by someone that your angry behavior is excessive, inappropriate, or out of control?