Agoraphobia Exposure & Avoidance Tracker
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Agoraphobia Exposure & Avoidance Tracker
Track avoidance patterns, safety behaviors, and exposure progress for agoraphobia treatment.
Client Information
Full name *
Your answer
Date
Avoidance Inventory (Past Week)
Rate avoidance level for each situation
Safety behaviors used
Exposure Practice
Exposure exercise attempted this week
Your answer
+ 7 more questions
About this template
Track avoidance patterns, safety behaviors, and exposure progress for agoraphobia treatment.
How does it work?
1
Click Use template. We'll drop a copy into your Formswrite workspace - no setup needed.
2
Tweak the questions, branding, and logic to fit your workflow. Add your logo, colors, and cover image.
3
Publish and share the link, embed it on your site, or drop it into a chatbot widget. Responses stream straight to your dashboard.