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10%

How often are you able to stay focused on the present moment?

Not At All

Several Days

More Than Half the days

Nearly Everyday

How often do you feel overwhelmed with your life?

Not At All

Several Days

More Than Half the days

Nearly Everyday

Do you fall asleep easily at night? (The average person falls asleep in 7-10 minutes.)

Not At All

Several Days

More Than Half the days

Nearly Everyday

On average, do you get 7-8 hours of sleep?

Not At All

Several Days

More Than Half the days

Nearly Everyday

Do you turn to unhealthy food indulgences such as eating junk food, drinking excessively, or eating sugary foods/sweets when feeling overwhelmed?

Not At All

Several Days

More Than Half the days

Nearly Everyday

Do you experience headaches or muscle tension?

Not At All

Several Days

More Than Half the days

Nearly Everyday

During work hours, do you have a hard time staying focused and concentrating on the task-at-hand?

Not At All

Several Days

More Than Half the days

Nearly Everyday

Do you feel pain or tension in your stomach, muscles, chest, or head?

Not At All

Several Days

More Than Half the days

Nearly Everyday

What are the key reasons for your stress/ anxiety?

Relationships

Family

Health

Financial

Work

Job Security

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