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Stress Survey

Instructions: Put a check in the box(es) next to the events(s) that have taken place in your life within the last 12 months to determine your level of stress.
1. Death of a significant other
2. Divorce
3. Marital separation
4. Jail term
5. Death of a close family member
6. Personal injury or illness
7. Marriage
8. Fired from work
9. Marital reconciliation
10. Retirement
11. Change in family member's health
12. Pregnancy
13. Sex difficulties
14. Addition to family
15. Business re-adjustment
16. Changes in financial status
17. Death of a close friend
18. Change to different line of work
19. Change in number of marital arguments
20. Mortgage or loan over $10,000
21. Foreclosure of mortgage or loan
22. Change in work responsibilities
23. Son or daughter leaving home
24. Trouble with in-laws
25. Outstanding personal achievement
26. Spouse begins or stops working
27. Starting or finishing school
28. Change in living conditions
29. Revision of personal habits
30. Trouble with boss
31. Change in working hours or conditions
32. Change in residence
33. Change in schools
34. Change in recreation habits
35. Change in church activities
36. Change in social activities
37. Mortgage or loan under $10,000
38. Change in sleeping habits
39. Change in number of family gatherings
40. Change in eating habits
41. Vacation
42. Christmas season
43. Minor violation of the law



Feeling stressed? Take this test.

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