Emotional Stress Survey

Get a personal assessment of your stress level

Take a few moments and fill out our Emotional Stress Survey. Its quick, easy and after you are done Dr. Davis will review your results personally.

Thank you for participating in our emotional stress survey. Your feedback is important. We would like to document how you feel before and after treatment at Crossing Back to Health so that you can see your progress and so that we can compile data to verify the effectiveness of our treatments for others.
  • Please inform us about how often you feel the following:
    Very OftenOftenOccasionallyRarelyNeverN/A
    Angry
    Anxiety
    Depressed
    Discouraged
    Energetic
    Exhaustion
    Fatigue
    Fear
    Frustration
    Grief
    Guilt
    Happy
    Hopeless
    Irritable
    Jealous
    Optimistic
    Overwhelmed
    Peaceful
    Relaxed
    Sad
    Shame
    Sleep Problems
    Stress
    Weighted Down
    Worry