DCA Athlete Stress & Recovery Questionnaire
First Name *
Your answer
Last Name *
Your answer
Class Period
August14,2017 *
MM
/
DD
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YYYY
1. Sleep Duration
2. Sleep Quality
3. Breakfast Quality
4. Mood
5. Energy Level
6. Personal Stress
7. Academic Stress
8. Soreness
9. Hydration (water intake)
10. Urine Color (most recent)
General Comments (Make notes of injuries, problems, specific situations, or ideas)
Your answer
Injury Survey (Identify your 3 most painful body sites and rate their severity on a scale of 1 for "very slight pain" to 5)
1.
Your answer
2.
Your answer
3.
Your answer
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