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Select your gender. 
 
Male
 
Female
 
 
 
What is the main source of your stress?
 
School work
 
social issues
 
appearance issues
 
parents
 
financial
 
 
 
how many hours of homework do you do a night?
 
0
 
1-2
 
3-4
 
5+
 
 
 
On a scale of 1-10 how stressed does school make you feel on a daily basis?
 
 
 
on a scale of 1-10 how much stress does your part time job cause you?
 
 
 
how many extra curricular activities do you participate in?
 
0
 
1-2
 
3-4
 
5+
 
 
 
on a scale of 1-10 how much stress do your extra curricular activities cause you?
 
 
 
do you feel that you enough enough time for school, a job, and extra curricular activities?
 
Yes
 
No
 
 
 
by trying to make time for everything, do your sleeping or eating habits get affected in an unhealthy way?
 
Yes
 
No
 
 
 
Do you feel like you are given enough time to complete homework/assignments and to study for tests?
 
Yes
 
No
 
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