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Stress Survey

Name: *
Today's date: *
How is your general health?
What are any health problems you have now?
How has your sleep been, and how is it now?
What have your dreams been like?
How often are you eating?
How nutritiously are you eating?
Are you exercizing?
Any recent weight changes?
Which direction and how much?
Any major stresses in the last 3 months?
What?
Any major stresses in the last year?
What?
How did the people you grew up with handle stress?
How do the people you live with now handle stress?
How do you handle stress?