Stress Impact Quiz

  • Your Stress Level Evaluation

    The following questionnaire is a comprehensive look at your stress triggers within the past year. It will take less than 10 minutes to complete
  • Gender

  • YOUR GENERAL HEALTH EVALUATION

    As of today do the below situations and events impact your life or cause stress? Please select YES or NO.

  • Yes= This event or situation is a stress Trigger for me

    No = This event or situation doesn't impact me. 

  • Death of Spouse*
  • Divorce*
  • Marital Separation*
  • Jail Term*
  • Death of Close Family Member*
  • Personal Injury Illness*
  • Marriage*
  • Fired at Work*
  • Marital Reconciliation*
  • Retirement*
  • Change in Health of Family Member*
  • Pregnancy*
  • Sexual Difficulties*
  • Gain of a New Family Member*
  • Business Readjustment*
  • Change in Financial State*
  • Death of a Close Friend*
  • Change in Responsibilities at Work*
  • Change in Number of Arguments with Spouse*
  • Foreclosure of Mortgage or Loan*
  • Change in Responsibilities at Home*
  • Child Leaving Home*
  • Trouble with In-laws*
  • Outstanding Personal Achievement*
  • Spouse Begins or Stops Working*
  • Begin or End School*
  • Change in Living Conditions*
  • Revision of Personal Habits*
  • Trouble With Boss*
  • Change in Work Hours or Conditions*
  • Change in Residence*
  • Change in Schools*
  • Change in Recreation*
  • Change in Church Activities*
  • Change in Social Activities*
  • Change in Sleep Habits*
  • Change in Number of Family Get-Togethers*
  • Change in Eating Habits*
  • Taking a vacation*
  • Celebrating Christmas*
  • Minor Violation of the Law*
  • Should be Empty: