San Antonio Faith-Based Initiative Questionnaire

Directions: The following statements ask about your thoughts, feelings, beliefs and behaviors in various situations. Using the scale provided, please choose the number that best describes you for each item. A 1 indicates it is NOT AT ALL true of you and 5 indicates that it is VERY true of you. Numbers 2-4 indicate how well it describes you in between these points. Think deeply about your answers and choose the number that comes closest to how you know yourself the best.
Disclaimer: This survey is completely anonymous. No personally-identifying information will be recorded. Only answer questions you feel comfortable answering. You may discontinue the survey at any time. Thank you for your participation.

What is your zip code of residence?

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* 1. What is your zip code of residence?

What is your gender?

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* 2. What is your gender?

What is your race/ethnicity?

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* 3. What is your race/ethnicity?

What is your age?

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* 4. What is your age?

In which of the following industries are you employed or intend to join?

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* 5. In which of the following industries are you employed or intend to join?

When I see people I do not know being sad, I feel a need to reach out to them.

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* 6. When I see people I do not know being sad, I feel a need to reach out to them.

I’m disapproving and judgmental about my own flaws and inadequacies.

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* 7. I’m disapproving and judgmental about my own flaws and inadequacies.

I accept others I do not know even when they do things I think are wrong.

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* 8. I accept others I do not know even when they do things I think are wrong.

When something upsets me I try to keep my emotions in balance.

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* 9. When something upsets me I try to keep my emotions in balance.

I respect others, no matter who they are.

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* 10. I respect others, no matter who they are.

When I’m going through a very hard time, I give myself the caring and tenderness I need.

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* 11. When I’m going through a very hard time, I give myself the caring and tenderness I need.

When people cry in front of me, I often don’t feel anything at all.

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* 12. When people cry in front of me, I often don’t feel anything at all.

One of the activities that provides me with the most meaning to my life is helping others who need help.

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* 13. One of the activities that provides me with the most meaning to my life is helping others who need help.

I believe that even strangers deserve my full respect.

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* 14. I believe that even strangers deserve my full respect.

I tend to feel compassion for people, even though I do not know them.

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* 15. I tend to feel compassion for people, even though I do not know them.

I give freely to others without expecting anything back.

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* 16. I give freely to others without expecting anything back.

When I feel inadequate in some way, I try to remind myself that feelings of inadequacy are shared by most people.

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* 17. When I feel inadequate in some way, I try to remind myself that feelings of inadequacy are shared by most people.

I pay careful attention when other people talk to me.

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* 18. I pay careful attention when other people talk to me.

I don’t concern myself with other people’s problems.

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* 19. I don’t concern myself with other people’s problems.

I try to avoid people who are experiencing a lot of pain.

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* 20. I try to avoid people who are experiencing a lot of pain.

I try to put myself in a stranger’s shoes when he or she is in trouble.

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* 21. I try to put myself in a stranger’s shoes when he or she is in trouble.

When I fail at something important to me, I become consumed by feelings of inadequacy.

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* 22. When I fail at something important to me, I become consumed by feelings of inadequacy.

I will sacrifice my own needs to meet the needs of others.

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* 23. I will sacrifice my own needs to meet the needs of others.

When I’m feeling down I tend to obsess and fixate on everything that’s wrong.

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* 24. When I’m feeling down I tend to obsess and fixate on everything that’s wrong.

I show kindness toward others whom I don’t know.

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* 25. I show kindness toward others whom I don’t know.

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