Tell us a little about yourself

  • Gender:      
  • Children:    
Your information is completely Private and Confidential
1 / 10
Q1. In the last 4 weeks how often have you
been upset because of something that happened unexpectedly
2 / 10
Q2. In the last 4 weeks how often have you
felt that you were unable to control the important things in your life
3 / 10
Q3. In the last 4 weeks how often have you
felt nervous or stressed
4 / 10
Q4. In the last 4 weeks how often have you
felt confident about handling your personal problems
5 / 10
Q5. In the last 4 weeks how often have you
felt that things were going your way
6 / 10
Q6. In the last 4 weeks how often have you
found that you could not cope with all the things you had to do
7 / 10
Q7. In the last 4 weeks how often have you
been able to control your irritations.
8 / 10
Q8. In the last 4 weeks how often have you
felt that you were on top of things
9 / 10
Q9. In the last 4 weeks how often have you
felt angry with things outside your control
10 / 10
Q10. In the last 4 weeks how often have you
felt that difficulties were so much that you could not overcome them