Thank you for taking the time to give us your opinion.

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  Stress related problems appear to be on the rise.  Are there solutions? 
Thank you for giving us your opinions.

What is the number one everyday stress in your life:
Job
Relationship
Money
Health
Fear (Please explain)
Other:

If you chose job, what are the reasons for this stress?
Undefined job description (always changing)
Work overload
Difficult Boss
Difficult co-workers
Deadlines
Expansion
Job Security
Harassment
Other:

In general, would you say your health is affected by your stress?                    
Definitely
Possibly
Sometimes
Never

Which of these ailments do you suffer from, and believe are related to stress?
Headaches
Nausea/upset stomach
Forgetfulness
Short tempter/Aggressiveness
Sudden Weight loss/weight gain
Difficulty sleeping or sleeping too much
Fearfulness
Consistent Colds
Other:

What do you do to relieve stress?           
Exercise
Therapy
Prescribed Medication
Bio-feedback
Music./Dancing
Animals/Pets
Schedule "play" time with friends
Alcohol./Non-prescriptive Drugs
Church/Prayer
Meditation/Yoga
Other:

On average, how many days do you miss from work due to stress related symptoms?
4+ times each year
1-3 times each month
Occasionally
Seldom
Never

On average, how often do you visit the doctor each year for minor problems that are "suggested" as possible reactions to stress?
4+ times each year
1-3 times each year
Occasionally
Seldom
Never


If there was a perfect solution to manage stress, what do you think that would be?

Do you feel you eat a balance and nutritious diet?    
4+ times each week
2-4 times each week
Occasionally
Seldom
Never

Do you smoke?
Occasionally
Seldom
Never

Do you drink alcohol?
Occasionally
Seldom
Never

Do you eat fast food, and food on the run?
Often
Occasionally
Seldom
Never

Do you take nutritional supplements?Daily
Occasionally
Seldom
Never

How often do you feel you must diet to maintain your weight?
Always
Occasionally
Seldom
Never

Any other comments on the stress of our population?

Thank you for your time.  The following information would also help us to understand the demographics of the opinions we receive.
Your Age
Male or Female

City and State
Profession
Number of years in this Profession/Job

If you would like to be contacted, please give us your email:

And tell us what we can do for you:

Thank you for your time.                                                             

If you would like to give your opinion in our Health Study, please click here: Health Survey

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