¬
Stress and Burnout Questionnaire

This brief inventory has been designed to help you discover the warning signals of excessive stress. Relate the questions to your life over the last 3 -6 months. Look particularly for changes in your ways of coping, not so much your normal behavior.  

Score 0 - for experiencing this only occasionally
Score 1 - This is true quite frequently (weekly)
Score 2 - This true often (usually daily)

1. Feeling constantly exhausted, tired or fatigued.    
2. Becoming increasingly irritable with a shortening fuse.   
3. Having less and less time for people, even family and friends.
4. Experiencing increasing difficulty making decisions.
5. Aware of increasing difficulty in concentration.
6. Feeling a sense of hopelessness, like "Why bother? "; "Who cares anyway ?" 
7. Chronic forgetfulness.
8. Regular sleep disturbance, wakefulness, never enough sleep.
9. Start the day feeling unrefreshed.
10. Frequent feelings of worthlessness.
11. Loss of enthusiasm or enjoyment of work.
12. Change in appetite; over-eating or loss of appetite.
13. Overlooking of normal duties or responsibilities.
14. Feeling unappreciated most of the time.
15. Feeling burdened by responsibilities and pressures.
16. Aware of accomplishing less and less in the time available.
17. Becoming excessively preoccupied with details.
18. Increasingly unable to say "No!" 
19. Becoming overly dogmatic, inflexible or "fussy."
2. Aware that you are driving yourself too hard at work or home.
21. Becoming cynical or hyper-critical with friends and family.
22. Increasing boredom with work, homelife or life.
23. Losing a clear perspective on work or life.
24. A growing sense of being "out of control" in areas of life.
25. Frequent somatic symptoms such as: Headache, chronic back ache, chest pain, abdominal cramps or wind, mouth ulcers, diarrhea, indigestion, skin rash, persistent colds, allergies, sinusitis, accidents, etc (1 point for each symptom)

Interpretation
A higher score indicates a very severe risk of burnout. 

Source: www.mindtools.com