Coping and Support Assessment
Please answer the following questions to help us understand your coping strategies and support systems.
Full Name
*
First Name
Last Name
Age
*
Gender
*
Female
Male
Non-binary
Prefer not to say
How would you rate your overall ability to cope with stress?
*
1
2
3
4
5
In the past month, how often have you used the following coping strategies when facing stress?
*
Rows
Never
Rarely
Sometimes
Often
Always
Seeking emotional support (talking to friends/family)
1
2
3
4
5
Problem-solving (making a plan of action)
6
7
8
9
10
Avoidance (ignoring the problem)
11
12
13
14
15
Physical activity (exercise, sports)
16
17
18
19
20
Relaxation techniques (meditation, deep breathing)
21
22
23
24
25
Substance use (alcohol, drugs)
26
27
28
29
30
Who do you most frequently turn to for support?
*
Family
Friends
Mental health professional
Religious/community leader
No one
Other
How satisfied are you with the support you receive from the following sources?
*
Rows
Very dissatisfied
Dissatisfied
Neutral
Satisfied
Very satisfied
Family
31
32
33
34
35
Friends
36
37
38
39
40
Work/School
41
42
43
44
45
Mental health professionals
46
47
48
49
50
Community groups
51
52
53
54
55
How often do you feel overwhelmed by your current stressors?
*
Never
Rarely
Sometimes
Often
Always
What are your top three sources of stress currently? (Select up to three)
*
Work/School
Family responsibilities
Health concerns
Financial issues
Relationships
Other
Please describe any additional coping strategies or support systems you find helpful.
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