Life Stress Questionnaire

Life goes through many phases and is frequently stressed by the ups and downs of them. Some of the crucial phases of life are education, marriage, career, parenthood, and retired life. Life stress questionnaire helps to find reasons of upset and worry and helps to resolve them.

Life Stress Questionnaire Sample:

Name:                       _______________________

Address:            _______________________

Phone Number:   _______________________

Email id:            _______________________

Age:                  _______________________

Q1. Can you list out some things that led to major changes in your life?


Q2. Have you experienced changes in your social life?

a)   Yes

b)   No

Q3. Are you sleeping habits proper?

a)   Mostly yes

b)   Sometimes yes

c)   Never

Q4. If you have children, do they bother you?

a)   Yes

b)   No

Q5. If your life overpowered by worries about future planning?

a)   Yes

b)   No

Q6. Do you have trouble with your parents or in-laws?

a)   Absolutely never

b)   Sometimes

c)   Very frequently

Q7. Are you taking or have taken major financial decision that has led to significant loss?

a)   Yes

b)   No

Q8. Do you have home loan or car loan to repay?

a)   Yes

b)   No

Q9. How is your relationship with your spouse?

a)   Strained

b)   Well managed

c)   No relationship

Q10. Do you have a healthy sexual life?

a)   Yes

b)   No

Q11. Did you suffer a loss of job?

a)   Yes, but long back

b)   No

c)   Yes and currently I’m a job seeker

Q12. Did you suffer a loss of reputation or have any litigation pending against you?

a)   Yes

b)   No

Category: Stress Questionnaire

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