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1. What is your age?

18 - 29
30 - 49
40 - 59
60 +
2. What is your gender?
Female
Male
Prefer not to say
3. What is your marital status?
Single
Married
Engaged
Divorced
4. Do you have children?
Yes
No
5. How often do you feel stressed?
Rarely
Sometimes
Often
Always
6. What is your level of stress?
Low
Medium
High
Extreme

7. What is your main cause of stress?


Work
School
Family
Friends
8. How long does your stress last?
One hour +
One day +
A few days
A week +
9. What reactions does your stress cause?
Anger
Crying
Over eating
Other
10. What do you do to reduce your stress?
Breathing exercise
Smoking
Exercise
Other

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