Burnout Questionnaire

How Close are you to Burning Out?

Complete the following questionnaire as honestly as you can.

Click the box that reflects the degree to which you agree with each statement using:

1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree

1) I struggle to cope with the demands and pressures of my working life.
2) It doesn’t take much to tire me out.
3) I find it hard to get to sleep and/or sleep soundly.
4) I rely on caffeine and sweet foods to give me the energy to keep going.
5) I feel I no longer have control over my life.
6) I have trouble waking up and pulling myself together in the morning.
7) I’m having to work harder and longer to achieve the same result.
8) I’m finding people irritating right now.
9) I crave something sweet, salty or fatty.
10) I’m forgetful. My memory is not what it should be.
11) I find it hard to focus and concentrate.
12) I’m more grumpy, irritable or moody than usual.
13) I’m impatient – I want things done quickly.
14) I’ve pushed back on socialising with family and friends.
15) I’m experiencing physical complaints – joint pain, headaches, stomach problems, viruses or allergies.
16) I feel low and sad.
17) I have no interest in sex.
18) People tell me I’m not myself at the moment.
19) I feel cynical and disenchanted with my life right now.
20) I’m exhausted in the evenings but often get a second wind.

Email Address (Only if you want to receive a copy of the results)

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