Stress Questionnaire Form

A stress questionnaire consists of questions that help to understand and measure the stress level, usually amongst city dwellers. The stress maybe due to the high-paced life or maybe due to the workplace issues, whatever the case, stress questionnaires help to identify the root cause. A stress questionnaire form consists of direct questions aimed at the respondent which enables to understand the reasons for stress. The questions in a stress questionnaire are formulated according to the target group. Such questionnaires help to quantify the level of stress experienced by the target group.

Stress Questionnaire Form Sample

Personal Information

Name of Individual:


Working Phone Number:


Zip Code:


Email ID:



Q1 Do you feel you are suffering from stress?

  • Yes
  • No

Q2 If yes, are there any visible signs of stress?

       (Answer Here)

Q3 What do you do when angry?

  • Shout at everyone
  • Throw things around
  • Try to stay calm

Q4 How often do you get a peaceful sleep?

  • Always
  • Sometimes
  • Rarely

Q5 Are you facing financial problems?

  • Yes
  • No

Q6 Do you like your working environment?

  • Yes
  • No

Q7 Do you think you have a good work and family balance?

  • Yes
  • No

Q8 When under stress, what do you do to relive your stress?

        (Answer Here)

Q9 When under stress, who supports you the most?

  • Family
  • Friends

Q10 Do you feel you have excessive workload and are unable to meet deadline?

  • Yes
  • No

Signature of the Individual__________________      

Date: _________________

Category: Stress Questionnaire

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