Panic Assessment Worksheet (Free PDF Download)

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What is the Panic Assessment worksheet?

The Panic Assessment worksheet is a two-page log a client fills in after a panic attack, not during one. Page one records time, date, where they were and what they were doing, then a symptom checklist split into Physical Symptoms and Emotional Symptoms.

How to use the Panic Assessment worksheet

Work through this sheet in session at the appointment after an attack, while the memory is still specific. Start with Where were you when the panic attack happened? and the activity beforehand, since context is easier to recall than symptoms. Then check the Physical Symptoms and Emotional Symptoms columns together, and rate the attack from 1 to 10. Your clients can leave the prevention question blank until a pattern appears across two or three entries.

Panic Assessment Worksheet Download – What’s Included

The download is two printable pages. Page one takes time, date, location and the situation before the attack. A symptom checklist follows, split into Physical Symptoms and Emotional Symptoms, with an Others line for anything missing. Page two asks how long it lasted, an intensity rating from 1 to 10, likely triggers, what the client did, and how they felt afterward.

Frequently asked questions

What symptoms does the panic assessment cover?

Two columns. Physical Symptoms lists racing heart, shortness of breath, chest pain or discomfort, dizziness, sweating, shaking and numbness. Emotional Symptoms lists fear of losing control, fear of dying and feeling detached from reality. An Others line lets the client add anything the checklist missed.

When should a client fill in a panic assessment?

As soon after the attack as the client can manage, while the sequence is still clear. Waiting until the next week usually produces a summary rather than a record. If arousal is still high, wait a few hours; the sheet asks for detail that is hard to reach mid-episode.

Used this worksheet in a session?

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Your Author

Tracy Collins, LCP

Tracy Collins is a licensed clinical psychologist with over six years of direct clinical experience in outpatient and telehealth settings. She specializes in cognitive behavioral therapy, structured treatment planning, and measurable therapy outcomes. Tracy has extensive experience writing SOAP and DAP notes, developing insurance-compliant treatment plans, and aligning documentation with ICD-10 and DSM-5-TR diagnostic criteria. Her clinical approach integrates cognitive behavioral therapy techniques, behavioral activation, exposure-based interventions, and mindfulness-based strategies to create structured and outcome-driven therapy plans. At Mentalyc, Tracy supports therapists by creating educational resources that simplify documentation workflows and improve treatment plan defensibility during audits.

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