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How Stressed Am I?
Have you ever wondered how stressed you are? Many times we are not aware of the level of stress that we are experiencing. The questionnaire consists of 10 scaling questions. Read each statement and answer each statement as it best describes you within the past 4 Weeks. If you have a sheet of paper by your side, write down the number you select for each question (e.g. 1 Strongly Disagree, 3 Neither agree nor disagree, 5 Strongly Agree). However, after submitting the assessment, you will receive a copy of your responses in your email. This assessment is for individuals 18 years or older, however, if you are the legal guardian of an adolescent you may assist in completing the questionnaire.
Please note that is assessment is not used to diagnose but rather bring self-awareness.
* Required
Email address
*
Your email
Age
*
20-29
30-39
40-49
50-59
60+
Other:
Occupation
*
Work full time
Work part time
Student
Work and go to school
Stay at home parent
Other:
Gender
*
Female
Male
Prefer to not disclose
Relationship Status
*
Married
Single
In a relationship
Divorced
1. I have NOT been able to have a restful night's sleep.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
2. I tend to be restless.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
3. I tend to have muscle tension
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
4. I tend to have low energy.
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
5. I tend have racing thoughts throughout my day
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Strongly Disagree
1
2
3
4
5
Strongly Agree
6. I tend to constantly feel fatigued
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Strongly Disagree
1
2
3
4
5
Strongly Agree
7. I tend to isolate myself
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Strongly Disagree
1
2
3
4
5
Strongly Agree
8. I tend to be easily frustrated
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Strongly Disagree
1
2
3
4
5
Strongly Agree
9. I tend to have headaches
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Strongly Disagree
1
2
3
4
5
Strongly Agree
10. I tend to have an upset stomach
*
Strongly Disagree
1
2
3
4
5
Strongly Agree
I know how my body and mind respond to stress
*
True
False
I know how to reduce my stress
*
True
False
I know my stressors
*
True
False
What To Do Next?
You will receive an email with your responses. After you submit this questionnaire, please click on the pdf document that will provide you with instructions on how to read your questionnaire. You will receive an additional email in your mailbox.
Privacy Policy
BeneVie Consulting PLLC, we respect the privacy needs of our valued customers and members. All responses given to BeneVie Consulting PLLC, including any personal information you provide, will be kept strictly confidential. Your input will only be used in combination with responses of other participating in the survey. Your individual responses are not shown to anyone.
BeneVie Consulting PLLC follows the strictest guidelines in terms of respondent confidentiality. If you have additional questions about our Privacy and Confidentiality Statement, please contact us at
teambenevie@benevieconsulting.com
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