Stress Questionnaire for Teenagers Sample:

Name: _______________________

Address: _____________________Phone Number: ________________

Email id: _____________________________

Q1:  Tick the right choice.

a)   I am a Student

b)   I am an Employee

c)   I am Self-employed

d)   I am looking out for a job

e)   NoneQ2: How often are you stressed out?

a)   Never

b)   Rarely

c)   Sometimes

d)   Frequently

e)   Always

Q3. If you are a student, why do you feel stressed out?

a)   Excessive coursework

b)   Examinations

c)   Placements

d)   Peer pressure

e)   Relationships

f)    Problems at home

g)   Others

Q4. If you are an employee, please tick the reasons for stress.

a)   Career

b)   Job

c)   Problems at home

d)   Relationship

e)   High expectations

f)    No work-life balance

g)   Financial turmoil

h)   Others

If ‘Others’, please specify ________________

Q5: If you are self-employed, then why are you stressed?

a)   Business uncertainties

b)   Loss in business

c)   No work-life balance

d)   Others

Q6. Do you allocate time for leisure activities?

a)   Yes

b)   No

Q7. Are you suffering depression?

a)   Yes

b)   No

c)   Sometimes

Q8. Are you confident of coming out of stressful situations?

a)   Yes

b)   No

c)   May be

Q9. What techniques do you use to come out of stress?

a)   Yoga or Exercise

b)   Meditation

c)   Pursue hobbies and interests

d)   Positive thinking

e)   Others

If ‘Others’, please specify _____________Q10. Are you friends supportive and helpful during stressful times?

a)   Yesb)   NoQ11:  Do you feel you suffer stress in your life?

____________________________

Q12: Can you provide some of the symptoms of stress?

__________________________

Q13: How often do you have peaceful sleep?

a)   Rarely

b)   Sometimes

c)   Mostly

d)   Almost everyday

Q14: Are you suffering a financial problem?

a)   Yes

b)   No

Q15: Do you have a good work-life/study-life balance?

a)   Yes

b)   No

Q16: Do you enjoy your time at work and at home or maybe U?

a)   Mostly yes

b)   Rarely yes

c)   NeverQ17: What steps do you take to relieve yourself of stressful situations?

____________________

Q18: Do you get the support of family, friends, and colleagues while suffering stress?

a)      Yes

b)      NoQ19: Are you getting into substances like alcohol, drugs or smoking for mitigating stress?

a)      Yes

b)      No

c)      Sometimes

d)     Rarely

Q20: Are you taking a healthy diet?

a)   Yes

b)   No

Q21: Are you suffering from excessive work load?

a)   Yes

b)   No

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