Symptoms of Stress

ID Number (W number) 

First Name:      Last Name:

Gender:       Age:   Major:

Classification:

Frequency of Symptoms

Symptoms

Almost all day, every day

Once or twice daily

Every night or day

2-3 times per week

Once a week

Once a month

Never

Headaches

 

 

Tense muscles, sore neck and back

Fatigue

Anxiety, worry, phobias

Difficulty falling asleep

Insomnia

Bouts of anger/hostility

Boredom, depression

Eating too much or too little

Diarrhea, cramps, gas, constipation

Tics, restlessness, itching

 

 

Click here to return to the main Assessment page