Break Your Barriers Quiz

First Name(Required)

Last Name(Required)

Email Address(Required)

Mobile Phone

1. Stress creates a strain on my relationships.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

2. I communicate my true feelings and thoughts in personal relationships.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

3. I am able to relax when spending time with others.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

4. I am scared of being judged by people close to me.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

5. I avoid social situations.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

6. I feel anxious at work.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

7. I frequently bring work home, physically or mentally.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

8. I work after hours.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

9. I am worried about not having enough money.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

10. I talk to clients out of working hours.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

12 I have difficulties focusing at work.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

13. I struggle to handle my personal problems.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

14. I get upset when things happen unexpectedly.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

15. I get angry when things are out of my control.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

16. I generally feel overwhelmed.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

17. I easily get teary and emotional.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

18. I get angry and frustrated quickly.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

19. I feel fidgety and restless.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

20. I feel hopeless.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

21. I feel that I am just not good enough.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

22. My mind is constantly wired to the problems in my life.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

23. No matter what I do, I still think something is missing.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

24. I find myself thinking about other things while in the company of other people.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

25. I am mentally hard on myself.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

26. I find it hard to make decisions.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

27. I feel tired and fatigued even after adequate amounts of sleep.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

28. I experience low libido.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

29. I need caffeine to get through the day.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

30. I struggle falling asleep or wake frequently throughout the night.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

31. I drink alcohol to relax.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

32. I find it easy to relax.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

33. I take enough time for myself.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

34. I nourish my body with healthy food.(Required)

Strongly disagree

Disagree

Neutral

Agree

Strongly agree

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Total Score

Hidden

Total Percentage Score

Break Your Barriers Quiz

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