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CALINOG NATIONAL COMPREHENSIVE HIGH SCHOOL

JUNIOR HIGH SCHOOL DEPARTMENT


SIMSIMAN, CALINOG, ILOILO

Name (Optional): Sex: Male Female


Grade & Section:
Age:

Directions: Check the box of your answer. Rate from 5-1 the stress you are feeling recently
from academic.
5 - Always
4 - Often
3 - Sometimes
2 - Seldom
1 – Never

Common stressors:
Examination
5 4 3 2 1
Assignments
5 4 3 2 1
Peer pressure/competition
5 4 3 2 1
Poor time management
5 4 3 2 1
Problems at home
5 4 3 2 1
Grades
5 4 3 2 1
Lack of support from friends, family, and teachers
5 4 3 2 1
Illness
5 4 3 2 1

Directions: Check the column of your answer.


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

Directions: Complete the questionnaire below by putting a check mark (✓) to the answer
that represents your opinion 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

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