1.How would you rate your current stress level?

Low

Moderate

High

2.How often do you feel overwhelmed by daily responsibilities?

Always

Sometimes

Rarely

Never

3.Have you experienced a traumatic event in your life that still affects you?

Yes

No

4.Do you feel you’ve had the space or tools to process difficult past experiences?

Yes

No

5.How supported do you feel by your social network (friends, family, etc.)?

Very supported

Somewhat supported

Not very supported

I don't have a support network

6.Have you ever spoken to a therapist, counselor, or resilience/life coach?

Yes

No

7.If not, what has prevented you? (Select all that apply)

Cost

Time

Stigma

I prefer to handle things on my own

Other

8.Would you consider resiliency coaching or counseling in the future if it were accessible and supportive?

Yes

No