Confidential Stress Assessment

Indicate to how often you have experienced in the past 30 days. Your responses and results are 100% CONFIDENTIAL. Upon completing this survey, you will be able to see the aggregated results of all participants.

Regarding your individual results, watch your email inbox within 48 hours of completing the survey with a link to set up your Complimentary Leadership Strategy session to receive a personal (not computer generated) review of your results and customized recommendations for leverage points for you to focus on now to avoid burnout and/or strategies to further increase your leadership capacity.

YOU MUST COMPLETE THE CONTACT INFORMATION FIELDS TO RECEIVE YOUR RESULTS!

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1. It takes more effort to face challenges with a positive attitude.

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2. During non-working hours, work continues to preoccupy my mind.

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3. I feel bored and have less enthusiasm for projects.

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4. At the end of the day I find the tasks I'm completing are not the most essential.

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5. I have difficulty prioritizing tasks.

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6. I find it difficult to concentrate and am easily distracted.

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7. I find it difficult to harness the energy required to produce quality work.

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8. I feel the need to isolate from other people because of my irritability.

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9. At home or at work, I have overreacted with an emotional outburst or increased hostility.

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10. I have difficulty getting out of bed and going to work in the morning.

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11. My thoughts continually focus on problems rather than on solutions.

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12. Even though I am “working harder,” spending more time on tasks, I no longer feel a sense of satisfaction when I finish.

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13. I feel tired and run down.

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14. I have noticed and/or my partner/spouse has complained I am spending more time watching television or on the computer.

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15. I have skipped work, cancelled meetings or spent more time in long lunch meetings rather than going back to the office.

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16. I have experienced one or more of the following: Sleep problems, headaches, back pain, colds, insomnia, rashes or hives, chest pains or palpitations, gastrointestinal problems, and nervous tics.

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17. I have increased my use of drugs (i.e., caffeine, nicotine, prescription medication, alcohol, or illegal drugs).

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18. I have noticed a significant increase or decrease in food intake/appetite.

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19. I am beginning to question whether my work is meaningful.

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20. I no longer find relief in spiritual, religious or recreational practices.

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21. I need to stay on top of my team members to be sure they are doing their job, or I risk the project not getting finished on time, on budget or with the quality I expect.

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22. I have found out that on one or more occasions, my team has withheld important information from me.

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23. I have felt "out of the loop" or actually been left out when it comes to receiving necessary information.

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24. I feel worried that my position or career could be on the line if I make another serious mistake or poor decision, fail to deliver or meet performance goals.

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25. I feel detached from my company's mission and/or purpose.

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26. I feel I must consistently compromise my personal or professional values to avoid "rocking the boat."

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27. My boss demonstrates that he or she cares about me as a person.

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28. I receive regular positive feedback and/or recognition about my work from my boss (not including performance bonuses).

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29. Question: How often do you invest in yourself to meet your professional and/or personal development needs so you can feel more energized, valued, focused and purposeful so you can ultimately perform better?

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30. Question: How often does your company invest in your professional and/or personal development needs so you can feel more energized, valued, focused and purposeful so you can ultimately perform better?

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31. What is your job role?

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32. Please complete the following information. Upon completion of the survey you will see the aggregated results. I will review your responses personally and contact you within 48 hours by email with your next steps to receive your results and recommendations.

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33. At what email address would you like to be contacted?

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