Math Anxiety Survey & Evaluation

Complete this questionnaire to assess math anxiety levels and receive personalized recommendations

Section A: Student Self-Assessment

Instructions: Select the number that best describes how much you agree with each statement. (1 = Strongly Disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly Agree)

Section B: Teacher Observation Checklist

Instructions: Select the option that matches how often you observe each behavior.

Section C: Causes & Triggers

For Students (short answers):

What situations in math class make you most anxious?

Do you feel supported by your teacher when you struggle?

How do your parents or peers talk about math?

For Teachers (short answers):

Which teaching methods seem to increase or reduce anxiety?

Do students respond better to collaborative or individual work?

How does assessment style (timed vs untimed, oral vs written) affect performance?

Section D: Remedy Testing

Interventions Tried (select all that apply):

Evaluation Metrics (short answers):

Pre- and post-intervention anxiety scores (from Section A)

Improvement in math test scores

Student feedback on confidence and enjoyment

Teacher observation of participation and engagement

Section E: Reflection

Which strategies reduced anxiety most effectively?

Which strategies had little or no impact?

How can successful remedies be scaled across classrooms?

What long-term supports are needed?

Math Anxiety Assessment Results

Self-Assessment Score

0

Not Assessed

Out of 35 possible points

Observation Score

0

Not Assessed

Out of 10 possible points

Overall Assessment

0%

Not Assessed

Based on combined metrics

Personalized Recommendations

Based on your assessment results, here are recommended strategies to address math anxiety:

Interventions You've Already Tried:

Key Insights from Your Responses:

Math Anxiety Survey & Evaluation Tool | Designed for educators and students

Complete all sections for the most accurate assessment and recommendations