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CALINOG NATIONAL COMPREHENSIVE HIGH SCHOOL

JUNIOR HIGH SCHOOL DEPARTMENT


SIMSIMAN, CALINOG, ILOILO

This questionnaire is administered to help students identify the stress they are
experiencing.

Name (Optional): Sex: Male Female


Grade & Section:
Age:

Directions: Check the column of your answer.


QUARTERS WITH WITH HIGH WITH HONOR NO HONOR
HIGHEST HONOR
HONOR
Q1
Q2
Q3

Directions: Complete the table below by putting a check mark (✓) to the answer that
represents your stress rate recently from academic.
5 - Always
4 - Often
3 - Sometimes
2 - Seldom
1 – Never

COMMON STRESSORS 5 4 3 2 1
Examination
Assignments
Peer pressure/ Competition
Poor time management
Problems at home
Grades
Lack of support from friends, family,
and teachers
Illness
Financial status
Others. Specify

Directions: Complete the questionnaire below by putting a check mark (✓) to the answer that
best help you cope with stress using the space provided.

COPING AGREE NEUTRAL DISAGREE


MECHANISMS TO
STRESS
Sleeping
Eating
Playing sports or
videogames
Hanging out with
friends
Spending time with
family
Exercising
Meditation
Listening to music
Others. Specify

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