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Hello:
You are invited to participate in our survey about SELF - ESTEEM. In this survey, approximately 75 people will be asked to complete a survey that asks questions about your self -Esteem. It will take approximately 15 minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

 
 
 
 
* I am very concerned about my appearance.
 
Always
 
Sometimes
 
Rarely
 
Never
 
 
 
* I often procrastinate due to my lack of interest.
 
Always
 
Sometimes
 
Rarely
 
Never
 
 
 
* I have not accomplished what I am capable of doing due to fear and avoidance.
 
Always
 
Sometimes
 
Rarely
 
Never
 
 
 
* I tend to think negatively much of the time.
 
Always
 
Sometimes
 
Rarely
 
Never
 
 
 
* I have avoided making changes in my life because I was fearful of making a mistake or failing.
 
Always
 
Sometimes
 
Rarely
 
Never
 
 
 
* I tend to magnify my mistakes and minimize my successes.
 
Always
 
Sometimes
 
Rarely
 
Never
 
 
 
* I am very critical of myself and others.
 
Always
 
Sometimes
 
Rarely
 
Never
 
 
 
* I feel inferior or inadequate as a child.
 
Always
 
Sometimes
 
Rarely
 
Never
 
 
 
* I often feel like I don't know what is expected of me.
 
Always
 
Sometimes
 
Rarely
 
Never