| 1. Do you eat more or less when stressed than when not stressed? |
| ___ More (10) | ___ Same/less (0) |
| 2. Do you worry over job, income or money problems? |
| ___ Yes (10) | ___ No (0) |
| 3. Are any of your relationships causing you stress? |
| ___ Yes (10) | ___ No (0) |
| 4. Do you often feel anxious? |
| ___ Yes (5) | ___ No (0) |
| 5. Do you often get upset when things go wrong? |
| ___ Yes (5) | ___ No (0) |
| 6. Do you lash out at others? |
| ___ Yes (5) | ___ No (0) |
| 7. Do you feel your sex drive is lower than normal for you? |
| ___ Yes (5) | ___ No (0) |
| 8. Do you feel isolated or lonely? |
| ___ Yes (3) | ___ No (0) |
| 9. Do you feel stressed due to lack of intimacy in one or more relationships? |
| ___ Yes (5) | ___ No (0) |
| 10. Have you had reduced contact with friends (feeling antisocial) or an increase in contact because you feel you need to vent your frustrations or stresses to others? |
| ___ Yes (3) | ___ No (0) |
| 11. Do you take any form of medication prescribed by a physician directly or indirectly related to stress in your life or for a psychological disorder? |
| ___ Yes (15) | ___ No (0) |
| 12. Do you commonly lose more than two days of work a year due to illness? |
| ___ Yes (5) | ___ No (0) |
| Total Score: _____ |
Return to "No Workout Workout" by Paul Chek
