Bach Flower Questionnaire
Answer the questions below to help determine which flower essences will help you. Once you submit the questionnaire, I will be in touch with you via email with your results within a week. Visit my website for more services or to reach me directly.  https://www.bachflowersbybecky.com
Sign in to Google to save your progress. Learn more
Name: *
Email Address *
Phone Number
Directions
Please read each question and answer by checking the appropriate box. Once you have finished the questionnaire, click "submit".
1. Do you hide your feelings behind a facade of cheerfulness? *
Required
2. Do you go out of your way to avoid burdening others with your problems and give in to the wishes of others in order to avoid conflicts or arguments? *
Required
3. Do you turn to food, work, alcohol, drugs, etc. when you are down? *
Required
4. Do you feel anxious without knowing why? *
Required
5. Do you secretly fear something bad will happen? *
Required
6. Do you wake up feeling anxious? *
Required
7. Do the small habits and idiosyncrasies of others bother you? *
Required
8. Do you focus on others mistakes? *
Required
9. Are you critical or intolerant of those who don't measure up to your standards or expectations? *
Required
10. Do you often neglect your needs in order to please others? *
Required
11. Do you find it difficult to say no to others when they want your help? *
Required
12. Do you tend to be easily influenced? *
Required
13. Do you often second-guess yourself? *
Required
14. Do you seek advice from others, mistrusting your own intuition? *
Required
15. Do you often change your mind out of confusion? *
Required
16. Do you fear losing control of your mind or body? *
Required
17. Do you have sudden fits of rage? *
Required
18. Do you fear losing control and hurting yourself or others? *
Required
19. Do you tend to make the same mistakes over and over? *
Required
20. Do you find that you don't learn from your past experiences? *
Required
21. Do you repeat the same patterns? *
Required
22. Do you need to be needed and want to keep your loved ones close? *
Required
23. Are you easily slighted and hurt? *
Required
24. Do you find yourself needing the attention and devotion of those you love, feeling it's their duty to stay in close contact with you? *
Required
25. Are you absentminded or does your attention easily wander, making it difficult to concentrate? *
Required
26. Do you find you have little interest in present circumstances, often daydreaming, wishing you were somewhere else? *
Required
27. Do you find yourself dozing off frequently, or sleeping more than necessary? *
Required
28. Do you feel overly concerned with cleanliness? *
Required
29. Do you feel unclean or physically unattractive? *
Required
30. Do you tend to obsess over little things? *
Required
31. Do you feel overwhelmed by your responsibilities? *
Required
32. Do you find it hard to cope under pressure? *
Required
33. Do you become depressed and exhausted when faced with your every day commitments? *
Required
34. Are you easily discouraged when things don't go your way? *
Required
35. When setting out to accomplish a task, do you become over-sensitive to small delays and and hindrances which may lead to self-doubt and at times to depression? *
Required
36. Is it hard for you to start over again once you've encountered difficulties? *
Required
37. Have you lost hope that you will recover from or be helped in overcoming an illness or difficulty? *
Required
38. Do you feel it is useless to seek further help for your problems? *
Required
39. Have you given up hope that things will change for the better in some circumstance or situation in your life? *
Required
40. Do you find others avoiding conversations with you because you talk a great deal? *
Required
41. Do you dislike being alone and seek the company of anyone willing to listen to your troubles? *
Required
42. Do you feel the need to steer conversations back to your special interests or problems, and are you reluctant to discontinue them even when the listener has to leave? *
Required
43. Are you suspicious and mistrusting of other people's motives and intentions? *
Required
44. Are you spiteful, envious, jealous, or vengeful? *
Required
45. Do you find yourself lacking compassion or warmth toward others? *
Required
46. Do you find you are caught between living in the present and dwelling on memories of the past? *
Required
47. Are there things you would have liked to do with your life, but never had the opportunity to do? *
Required
48. Do you find yourself reminiscing about the good old days, wishing you were able to live your life over again? *
Required
49. Do you often feel too tired to face the day ahead? *
Required
50. Do you feel overworked or bored with your life? *
Required
51. Do you tend to put things off? *
Required
52. Do you find it hard to wait for things? *
Required
53. Do you find yourself losing patience, becoming tense and irritable with people and things that move too slow? *
Required
54. Do you find you need to work alone, because others can't keep up to your pace? *
Required
55. Do you lack self-confidence? *
Required
56. Do you not try things for fear of failing? *
Required
57. Do you feel inferior and often become discouraged? *
Required
58. Do you have specific fears you can identify and would like to overcome? *
Required
59. Are you shy, overly sensitive, and modest? *
Required
60. Do you get nervous and embarrassed? *
Required
61. Do you get depressed without any reason? *
Required
62. Do you feel this gloom, for no apparent reason lifts as suddenly as it comes? *
Required
63. Do you feel your mood swinging back and forth? *
Required
64. Do you tend to overwork and keep on in spite of exhaustion? *
Required
65. Do you have a strong sense of duty and never give up? *
Required
66. Do you neglect your own needs in order to complete a task? *
Required
67. Are you now going through, or have you recently gone through, an illness or personal ordeal which left you physically and mentally drained? *
Required
68. Do you tire easily with no reserve energy to complete your tasks or enjoy the day? *
Required
69. Do you feel sapped of strength and vitality, where even the least of effort exhaust you? *
Required
70. Do you often feel guilty? *
Required
71. Are you rarely content with your accomplishments, feeling you could always do better? *
Required
72. Do you blame yourself for other people's mistakes, feeling guilty that their shortcomings are in some way your fault or responsibility? *
Required
73. Are you overly concerned and worried about your loved ones? *
Required
74. Do you get distressed and disturbed by other people's problems? *
Required
75. Do you worry that harm may come to those you love? *
Required
76. Are you susceptible to feelings of terror and panic? *
Required
77. Do you become helpless and frozen in the face of your fear? *
Required
78. Are you troubled by nightmares? *
Required
79. Do you set high standards for yourself? *
Required
80. Are you strict with your health, work, and/or spiritual discipline? *
Required
81. Are you very self-disciplined, always striving for perfection? *
Required
82. Do you suffer from indecision, uncertainty, or hesitancy? *
Required
83. Do you have difficulty choosing between one thing and another? *
Required
84. Do you experience extreme mood swings or have difficulty keeping your balance? *
Required
85. Do you feel devastated due to a recent shock? *
Required
86. Do you feel withdrawn due to traumatic events in your life? *
Required
87. Have you recently, or in the past, suffered a personal loss which you haven't quite gotten over? *
Required
88. Do you feel extreme mental or emotional heartache? *
Required
89. Do you feel you have reached the limits of your endurance? *
Required
90. Are you in complete despair with all hope gone? *
Required
91. Do you get high-strung and very intense? *
Required
92. Do you try to convince others of your way of thinking? *
Required
93. Are you sensitive to injustice, almost fanatical? *
Required
94. Do you tend to take charge of projects, situations, etc? *
Required
95. Do you consider yourself a natural leader? *
Required
96. Are you strong-willed, ambitious, and often bossy? *
Required
97. Are you currently in a state of transition or change? *
Required
98. Do you get drained by people or situations? *
Required
99. Are you involved in a relationship or situation you would like to be free of but cannot break away from? *
Required
100. Do you give the impression that you're aloof? *
Required
101. Do you prefer to be alone when overwhelmed? *
Required
102. Do you feel you often don't connect with people? *
Required
103. Are you troubled by persistent, unwanted thoughts? *
Required
104. Do you relive unhappy events or arguments over and over again? *
Required
105. Are you unable to sleep at times because you can't stop thinking? *
Required
106. Do you feel that you can't find your path in life? *
Required
107. Do you feel you are drifting in life and can't find direction? *
Required
108. Are you ambitious but don't know what to do? *
Required
109. Do you find you are indifferent and apathetic toward life? *
Required
110. Are you resigned to your current circumstances, making little effort to improve things or find joy? *
Required
111. Do you feel you've given up and don't care one way or another what happens? *
Required
112. Through no fault of your own, do you feel that life has been unfair or unjust to you? *
Required
113. Have you become resentful and bitter to those who may have treated you poorly? *
Required
114. Despite all you have done, do you feel your best efforts have largely gone unrewarded, while others not as deserving as yourself, have gained? *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms