Stress is part of our lives. Stress can be sudden, short lived or prolonged. Different kinds of stress have different effects and complications. This questionnaire is designed to help you and your physician identify whether you are currently showing any signs of stress. If you feel that you are unduly stressed please remember to consult an appropriate health care professional.

Each question has several responses from which you are asked to choose the one that best describes your own situation. Please be sure that you select only one response per question.

Please ensure all information is completed correctly in order for us to respond to your assessment promptly.

Self Assessment - Stress

Over the past six months:

Submit your self assessment form to the Mens Clinic International Doctor for evaluation: