Skip to content
Respite In Place: Pre-Session Survey
Before joining us, tell us about your current situation.
1.
On a scale from 1 to 5, with 1 being the least stressed and 5 being the most stressed, how stressed are you?
1 Least stressed
2
3
4
5 Most stressed
1 Least stressed
2
3
4
5 Most stressed
2.
How appreciated do you feel?
1 Not appreciated
2
3
4
5 Appreciated
1 Not appreciated
2
3
4
5 Appreciated
Please share any additional comments.
3.
How understood do you feel?
1 Misunderstood
2
3
4
5 Understood
1 Misunderstood
2
3
4
5 Understood
Please share any additional comments.
4.
How supported do you feel?
1 Not supported
2
3
4
5 Supported
1 Not supported
2
3
4
5 Supported
Please share any additional comments.
5.
How easy is it for you to take time for yourself?
1 Easy
2
3
4
5 Difficult
1 Easy
2
3
4
5 Difficult
Please tell us more.
Current Progress,
0 of 5 answered
