Preventive Measures Computerized Stress Inventory Survey

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Please enter Your Name or Code Number.
(You may use your real name, a pseudonym, or a code number. Make a note somewhere else of the name or number you use so that you will be able to identify your Stress Profile.)

Please enter Your Name or Code Number. (You may use your real name, a pseudonym, or a code number. Make a note somewhere else of the name or number you use so that you will be able to identify your Stress Profile.)

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Please enter your email address (so we can send your stress profile to you).

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Please re-enter your email address

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Please enter your age in years.

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Your sex

Your sex Female

Male

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Your marital status:

Your marital status: Single

Married, for the first time

Remarried

Divorced

Separated

Living with a lover

Widowed

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Are you currently involved in a primary or special relationship?

Are you currently involved in a primary or special relationship? Yes

No