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This survey is part of a project by Senior Nursing Students to better help you manage your stress. Please read the following informed consent and check "agree" if you would like to continue.

By taking this survey I am giving consent for my answers to be used for research purposes only. I understand that no personal identifying information will be asked of me and all answers will be kept confidential.
 
 
 
 
* Are you male or female?
 
Male
 
Female
 
 
 
* What is your classification?
 
Freshman
 
Sophomore
 
Junior
 
Senior
 
 
On a scale of 1 to 10 how much does stress affect your life on a daily basis? (1 being little effect, 10 being overwhelming effect)
1 2 3 4 5 6 7 8 9 10
*  
 
 
 
* What things cause you stress? (Select all that apply)
 
School/Homework
 
Home Life
 
Work
 
Relationships/Friends
 
Extra Curricular Activities
 
Other

 
 
 
* How many days do you exercise 30 minutes or more per week?
 
0
 
1-3
 
3-5
 
5-7
 
 
 
* On average how many hours of sleep do you get per night?
 
1-5
 
6-7
 
8-10
 
10+
 
 
How do the following affect your stress level?
Increases Stress Does not effect Decreases Stress
* Physical Activity
* Sleep Habits
 
 
 
* How do you perceive your eating habits?
 
Very unhealthy
 
Somewhat unhealthy
 
Average
 
Somewhat healthy
 
Very healthy
 
 
 
What things help you in reducing stress?
   
Any questions or concerns about your overall wellbeing?
   
 
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