Stress Survey Questionnaire
A stress survey questionnaire contains information that relates to an individual’s reaction to different situations presented in life. Through a well defined stress survey questionnaire, doctors and psychiatrists can even find solutions for stress management. This type of questionnaire also helps people under stress to identify their problem areas and thus provides them with the necessary direction.
Stress Survey Questionnaire Sample
Name of the individual: ________________________________
Age: ______ Sex: _______ Occupation: ______________________
City: ________________ State: ___________________ Zip: _________________
Telephone: ____________________ Fax: ____________________________
Q1. Which of the following symptoms have you noticed in the last few months?
d) Dry mouth
e) Compulsive eating
f) Muscle ache
i) Addictive behavior
j) Irritable behavior
Q2. How much fun experience is there in your everyday life?
a) Quite a lot
b) A few fun moments
c) Occasional moments
d) None at all
Q3. What according to you contributes the most stress in your everyday life?
f) Crowded places
Q4. Do you sleep well?
Q5. How often do you exercise or participate in physical activity?
a) Once a day
b) Once in two or three days
c) Once in a week
d) A few days in a month
e) No exercise at all
Q6. What do you do when you feel stressed?
a) Take pre-emptive action
b) Take a break
c) Take the day off
d) Watch a movie
e) Keep myself pre-occupied
g) Do nothing special
Q7. When you are stressed, what type of behavioral attitude do you have?
Q8. Do you let your stress affect your family life?
Q9. Do you let your stress affect your work life?
Category: Stress Questionnaire
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