Need Help with Health Coach Psychology Forms

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I have to see a health coach to get access to healthcare at the appropriate low-cost clinic my insurance will cover. That's not so bad except she's a quasi-therapist as well. I've had other low-cost therapists unwilling to recognize my prior diagnosis of Aspergers with a high-cost psychologist/neuropsychologist so I haven't brought it up with her. She doesn't even seem to know how PTSD works so I'm guessing she has no idea about Aspergers either! She seems to think PTSD is a behavior problem caused by thinking wrong rather than intrusive memories causing a person to re-experience trauma.

Anyway, I'm being "treated" for my PTSD (I suffered childhood molestation, abuse, rape in young adulthood, was beaten, stabbed, witnessed violence against humans and animals, etc.) by filling out these form things about my thoughts. The problem is that I'm a very visual and sensory thinker and I strongly feel that I do not dare put down what my actual thoughts are because I'd be describing imagery and feelings in a sensory way.

The forms go like this:

Situation: Who, what, when, where / Feelings: What did you feel? Rate your emotion 0-100% / Thoughts: What was going through your mind as you started to feel this way?

I have to write down situations when I have strong negative feelings of some kind and fill in those blanks about them. If you think in images, too, you can probably literally see how this would be a pain in the butt. She'll probably assume I have some kind of mental illness I don't have if I fill the forms in honestly and accurately. I also don't have any way to gauge what percentage of my feelings are a particular feeling.

My partner thinks I can write down exactly what I'm actually thinking and feeling but I have an extremely strong suspicion that she'll label me something I don't have if I write something like:

Situation: I was folding the towels at around 5pm in the the laundry room of my apartment.
Feelings: Anxiety 60% (I have to make up a fake percentage number no matter what!) Agitation 10%
Thoughts: Laundry soap smell, flickering light, red, hammer hitting wall, sock falling to floor, mouth is dry

So I'm guessing I have to come up with some normal fake answers.

I wish I didn't have to jump through these extra hoops to get healthcare for my lupus, fibromyalgia, thyroid disease, etc.

Any ideas of good normal things to say I'm thinking? I thought of saying "I was thinking I feel anxious and agitated" but that sounds stupid even to me.

I guess I'll go with saying I'm thinking that I'm experiencing whatever emotion(s) I put in the emotion segment. I'm not sure what else to write.