Stress Management Health Awareness Survey Form
Please complete this survey to help us understand your stress levels and health awareness. Your responses are anonymous and will be used for wellness insights.
How often do you feel stressed in a typical week?
*
Rarely
Sometimes
Often
Almost always
On a scale of 1 to 5, how would you rate your current level of stress?
*
Very low
1
2
3
4
Very high
5
1 is Very low, 5 is Very high
How much does stress affect your daily activities?
*
Not at all
A little
Moderately
Significantly
Which of the following do you use to manage stress? (Select all that apply)
*
Physical exercise
Meditation or mindfulness
Talking with friends/family
Hobbies or creative activities
Professional support
Other
How aware are you of your main sources of stress?
*
Not aware
1
2
3
4
Very aware
5
1 is Not aware, 5 is Very aware
How frequently do you engage in healthy habits to reduce stress?
*
Rarely
Occasionally
Frequently
Always
Please rate your sleep quality over the past month.
*
1
2
3
4
5
How confident are you in your ability to manage stress effectively?
*
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
In the past month, which symptoms have you experienced during stressful periods? (Select all that apply)
*
Headaches
Fatigue
Difficulty sleeping
Irritability
Digestive issues
None of the above
Please indicate your agreement with the following statements about stress and health.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I recognize when I am stressed
1
2
3
4
5
I know effective ways to reduce stress
6
7
8
9
10
I believe stress impacts my physical health
11
12
13
14
15
I seek support when feeling overwhelmed
16
17
18
19
20
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