Apollo Lifeline NATIONAL : 1860-500-1066
Joint Commission International.
Joint Commission International.

Stress Assessment

Name *
Age *
Gender *
Email *
Mobile Number *
Location *
I'm *
1. Do you experience an increase in headaches, body pains in the neck, shoulders and low back? *
2. Have you in the past two weeks felt anxious , agitated, unable to relax or in low moods? *
3. Have you of late been forgetful, indecisive or noticed that your judgment is not as good as it was? *
4. Do you have disturbed sleep and wake up feeling tired and unrefreshed? *
5. Have you noticed a change in your appetite; a desire to binge or over eat or skip meals at other times? *
6. Do you feel there are too many deadlines in your life that are difficult to meet? *
7. Are you dissatisfied in your current job with regard to income and opportunities for career growth? *
8. Have you been neglecting your personal life because of your work? *
9. Do feel pressured or stressed by daily chores at home? *
10. Do you feel the hours in a day are not enough to complete all the work you must do? *
11. If a situation annoys you, do you bottle up your feelings rather than express them? *
12. Do you quite often find yourself thinking about your problems and unable to relax or let go? *
13. Do you feel annoyed and become restless when you have to wait in queue or in a slow moving traffic? *
14. Do you find doing most jobs yourself to ensure that they are done properly? *
15. Do you enjoy competing ,always try to win in games or activities? *
16. Are you currently facing personal crisis such as death of a loved one or life threatening illness in the family ,or financial loss? *
17. Do you miss emotional closeness to members of your family and feel lonely and depressed? *
18. Do you find yourself to be emotional and frequently react by aggressive outburst or crying? *
19. Is your life so busy that you cannot set aside time for pursuing personal interests like music, reading, fitness activities, yoga? *
20. Do you lack close friends or relatives you can readily turn to for help and support? *
21. Are you currently using any of the following to feel better- smoking , alcohol, drugs or use of paan/gutka, excess coffee? *
22. Do you tend to reach out to social media, chats /games to feel better? *

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