Step 1 of 33 3% First Name(Required)Last Name(Required)Email Address(Required) Mobile Phone1. 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 This field is hidden when viewing the formTotal ScoreThis field is hidden when viewing the formTotal Percentage Score Δ
