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