Anger Management Evaluation Form
Name
First Name
Last Name
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Describe the event triggered your anger
Rate your anger level
1
2
3
4
5
What were the first symptoms of your anger?
What were you feeling?
Sad
Scared
Hurt
Frustrated
Furious
Annoyed
Enraged
Other
What physical cues did you notice as you got angry?
What were your actions? (What did you say or do?)
What anger management steps did you apply?
STEP 1 (I admitted that I am angry, to myself and/or to someone else.)
STEP 2 (I believed I can control my anger &Â told myself that I can!)
STEP 3 (I calmed down. Controlled my emotions. Take some time for myself, breath deeply, count to ten, cry...did whatever works for me.)
STEP 4 (I decided how to solve the problem once I calmed down. Figure out what I need, and what's fair.)
STEP 5 (Expressed myself assertively. Asked for what I need. Speak calmly, without yelling, and people listened to me.)
What, if anything, would you do different next time?
Submit
Should be Empty: