Telecommuting Stress Fatigue Assessment
Please complete this assessment to help us understand your experiences with remote work and identify areas for support.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Job Title / Role
*
How long have you been telecommuting?
*
Please Select
Less than 1 month
1-3 months
3-6 months
More than 6 months
On a scale of 1 to 5, please rate the following aspects of your remote work experience:
*
Rows
1 (Very Low)
2
3
4
5 (Very High)
Overall stress level
1
2
3
4
5
Fatigue or tiredness
6
7
8
9
10
Work-life balance
11
12
13
14
15
Productivity
16
17
18
19
20
Motivation
21
22
23
24
25
Ability to focus
26
27
28
29
30
How often do you experience the following symptoms while telecommuting?
*
Rows
Never
Rarely
Sometimes
Often
Always
Headaches
31
32
33
34
35
Difficulty sleeping
36
37
38
39
40
Irritability
41
42
43
44
45
Feeling overwhelmed
46
47
48
49
50
Physical exhaustion
51
52
53
54
55
How satisfied are you with the following aspects of your remote work setup?
*
Rows
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
Communication with team
56
57
58
59
60
Support from management
61
62
63
64
65
Access to necessary resources
66
67
68
69
70
Home office environment
71
72
73
74
75
What are your biggest challenges with telecommuting?
Staying motivated
Managing distractions
Work-life balance
Communication barriers
Physical discomfort
Other
Please describe any strategies you use to manage stress or fatigue while working remotely.
What additional support or resources would help you manage stress and fatigue?
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