Stress Questionnaire Example

Every individual faces stress in their lifetime, but city dwellers are faced with much higher level of stress. A stress questionnaire helps to determine the stress level trends amongst people. Stress can lead to many other physiological as well as psychological issues, therefore studying the effects of stress is very important. A stress questionnaire example consists of the typical questions included in a stress questionnaire.

Stress Questionnaire Example Sample

Name _________________________________

Current Address _____________________________

Telephone Number _______________________________

Age ____________________________________________

Designation ____________________________

Email ID _____________________________

Q1: Do you suffer from stress?

• Yes
• No

Q2: If yes, what symptoms can you comprehend for stress?

_________________________________________________

Q3: Would you say you are able to get enough sleep?

• Yes
• No
• Sometimes
• Rarely

Q4: Do you have a good work-home balance?

• Yes
• No

Q5: When faced with stressful conditions, what do you do to combat it?

• Try sleeping
• Increase my appetite
• Indulge in various activities such as reading, writing, gardening etc.
• Become upset and remove anger on others
• Others: _____________________________________

Q6: Amongst the following which is the major cause of stress in your life?

• Job
• Relationship with spouse
• Relationship with other family members
• Other issues __________________________

Q7: At the end of the day, do you feel emotionally and physically drained out?

• Yes
• No

Q8: How do you spend your free time/ leisure time?

_________________________________________

Q9: Are you satisfied with your working environment and your designation?

• Yes
• No

Q10:  Do you indulge in cigarette, tobacco, drugs or alcohol abuse?

• Yes
• No