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Getting Over Stage Fright Survey

Your Privacy is Important

In The SpotLight is committed to maintaining your privacy. Any information submitted to In The SpotLight through this web site or otherwise is held in strictest confidence and is never given out to anyone for any reason. We do not sell or otherwise make available our mailing list. Read our complete Privacy Policy.

Thank you for taking a few moments to complete this survey. Your responses are strictly confidential and will never be disclosed in any way that will identify you individually. The information you share will help Janet learn more about peoples’ experiences with the fear of public speaking and performing. It will also help her better understand what you most need and want to help you with this challenge. To thank you for your participation, you will receive a list of Top Ten Tips for Reducing Stage Fright once you submit your completed survey.

At what age did your problem with stage fright begin?

How many years have you had this problem?

Please describe the first experience of stage fright that you remember.

Please describe how your problem with stage fright has progressed over time.

A response is required.

Please describe your symptoms of stage fright. What goes on in your mind and body BEFORE, DURING AND AFTER a speaking or performing event?

A response is required.

How has this problem affected your life professionally or academically?

A response is required.

How has this problem affected your life personally, especially related to your confidence and self-esteem?

What efforts have you made to cope with this problem thus far and how successful have these efforts been?

A response is required.

What are your 3-5 most important needs to help you with this challenge?

A response is required.

Please let me know if you are interested in attending a Getting Over Stage Fright Workshop, having a personal consultation or coaching session, or would like to suggest any products, services, or events you would like me to offer to help you at this time. Also include any locations in which you would like to see my workshop held and we will consider all requests.

A response is required.

Your age?

Sex Female Male

Enter your occupation in the space provided below.

Your highest educational level:

City and state of residence (for demographic purposes only):

You will be added to our email list to receive our In The SpotLight newsletters and occasional announcements of things Janet is offering to help people with speaking or performing anxiety. Please indicate if you do not wish to be on this list. Please note that we keep your contact information in strict confidence within our organization and we do not sell or rent our email list.

Yes, put me on the list. My email is:

No, do not put me on your mailing list now.

Are you interested in attending a Getting Over Stage Fright Workshop or having a private consultation or coaching session with Janet?

(Again, be sure to include your email address if you want us to contact you as we usually do our follow-up communications via email. Please note if you prefer a call and provide the best phone number to reach you.)

If you want to be on the list for our In The SpotLight newsletter, please provide your first name and email address and as much of the following information as you wish. Please know that your information will be held in strict confidence and will never be shared with anyone outside of our organization.

Last Name
First name
Street Address
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

NOTE: YOUR EMAIL IS NOT REQUIRED FOR THE SURVEY, BUT WE CAN NOT ADD YOU TO THE LIST IF YOU DO NOT INCLUDE YOUR EMAIL ADDRESS AS WE SEND OUT OUR NEWSLETTER AND OCCASIONAL ANNOUNCEMENTS BY EMAIL.

Any further ideas, questions or comments? Please let us know if you prefer to be contacted by phone rather than by email and be sure to provide your email address and/or phone number if you wish to be contacted. Also, we'd like to know how you found our web site (which search engine or link, from a friend, other way) and what key words or phrases you used for your search.

Thanks again for taking time to complete this survey. Janet greatly appreciates learning about your experience and needs in dealing with this challenge. When you click "Submit" you will be taken to a page where you can download your FREE copy of the Top Ten Tips for Reducing Stage Fright. We hope that you will find them helpful.