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Take our Stress Survey

1. Do you feel burned out? Yes No
2. Have you lost your appetite, or are you overeating? Yes No
3. Do you have trouble sleeping, or do you wake up a few hours earlier that usual? Yes No
4. Do you feel anxious or worried without any obvious reason? Yes No
5. Have you had any major changes in life? A new baby? Death? Relocation? Job changes? Yes No
6. Do you feel annoyed and irritated with people and feel you are the only sane one out there? Yes No
7. Do you find that losing your keys or a brief traffic delay sets you off? How about a slow computer? Yes No
8. Do you smoke tobacco or drink alcohol to have a break or to de-stress or to go away? Yes No
9. Are you overweight? Could you stand to lose 10+ pounds? Yes No
10. Do you experience/Have you experienced a bad back or neck? Do you have knots in your shoulders? Can you turn and bend your head/back equally to all sides with no tightness or catches? Yes No
11. Are you exhausted at the end of the day? Yes No
12. Have you experienced palpitations, increased pulse, increased breath rate, butterflies in stomach, heartburn, etc.? Yes No
13. Would you like to get rid of any of the above? Yes No

When you have completed the survey, please click the 'Get Score' button to see your score!

This survey is not to be used in place of a professional diagnosis.

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Better Health Through Chiropractic, Ltd. · 4727 East Bell Road, Suite 61 · Phoenix, AZ 85032
Phone Number: (602) 992-2060 · Fax Number: (602) 992-0143 · info@phoenixchiro.com