I made this up based on stuff I found on the Internet! Unfortunately, I can't remember where!

1.  What job(s) do you do?  Describe your daily routine.

2.  How often do you feel stressed at work? (circle one)
    constantly      every day     a few times a week
    once a week    once a month     only on deadline days     never

3.  Do you feel comfortable with your level of stress at work? If not, what would make your stress more manageable?

4.  Is your level of stress inherent to your job? Do you think it's possible to reduce the stress in your job to a more reasonable amount?

5.  Rank the following factors that contribute to your work stress with a 1, 2, 3, or 4. "1" means the factor produces no stress to you; "2" means it produces a little stress; "3" means it causes moderate stress; and "4" means it causes a lot of stress.

    ___ deadlines     ___ schedules         ___ work loads   ___ bosses
    ___ physical work environment    ___ coworkers in the office
    ___ contacts out of the office         ___ equipment (computers, phones,  …)
    ___ repetitive tasks     ___ other: _________________________

6.  What factors do you think cause the most stress in your job?

7.  Do you feel comfortable approaching your boss with stress-related issues? Why/why not?

8.  What elements, if any, of the physical work environment cause you stress?

9.  How often does stress at work affect your personal life?

10.  How often is the stress you feel at work a result of stress in your personal life? What actions could you take to help you reduce the stress in your personal life?

11.  How do you best deal with stress?

12.  What effects have you experienced as a result of work stress? For example:
    emotional or psychological or other ….

13.  What suggestions do you have for improving the quality of life at work or at home?

14.  What other sources of stress do you have in your life?  How do they affect your perception of stress?

15.  Having answered all these questions, decide on your level of stress:

Low  Moderate  Average  Above Average  High  Dangerous

16.  Together suggest some ways to minimize stress in your lives.