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Personal Stress Self Assessment

Congratulations! Taking time do a personal stress self assessment can give you the information you need in a simple, straight-forward report that allows you to see your life with fresh eyes.

Your name and email information is requested in order to send you your responses and will not be retained by this website.

Please take your time and give yourself all the information you need regarding the stressors you have experienced in your life, including when and for how long you may have been exposed to a particular stressor, adding any comments that may shed insight into the situation.

Thank you!

Assess Your Stress Factors
Please note that all fields followed by an asterisk must be filled in.
First Name*
E-mail Address*
Loss of a loved one
Loss of a job or business
Change of job or career
Change of workplace or role at work
A move - relocation
Marriage
Pregnancy
Miscarriage or abortion
Separation
Divorce
Illness of a loved one
Alcohol or drug addiction
Alcohol or drug addiction of a loved one
Physical abuse
Emotional abuse (bullied, rejected, humiliated)
Sexual abuse
Financial abuse
Other stressors
What supports do you have in place?

Please enter the word that you see below.