Mid-Program Stress Assessment
Help us understand your current stress levels and experiences so we can better support you during the program.
Participant Name
*
First Name
Last Name
Email Address
*
example@example.com
Program Name
*
How would you rate your current overall stress level?
*
No Stress
1
2
3
4
5
6
7
8
9
Extreme Stress
10
1 is No Stress, 10 is Extreme Stress
Please indicate how much you agree with the following statements:
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am able to manage my workload effectively.
1
2
3
4
5
I feel supported by program staff or mentors.
6
7
8
9
10
My stress is affecting my performance.
11
12
13
14
15
I have healthy coping mechanisms for stress.
16
17
18
19
20
I am able to balance program and personal responsibilities.
21
22
23
24
25
What are your main sources of stress at this point in the program?
*
Workload
Time management
Personal issues
Program expectations
Peer relationships
Other
Which coping strategies have you used recently?
Exercise or physical activity
Talking to friends/family
Meditation or mindfulness
Taking breaks
Seeking professional support
Other
How confident are you in your ability to manage stress for the remainder of the program?
*
Very confident
Somewhat confident
Neutral
Somewhat unconfident
Not confident at all
Would you like additional support or resources from the program?
*
Yes
No
If yes, please specify what kind of support would be helpful:
Please share any additional comments or suggestions regarding your experience so far.
Submit Assessment
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