How Are You Doing?

1.) What do you Identify as?
Male
Female
Prefer Not to Say
2.) Do you currently attend high school? (If No please skip to question 8)
Yes
No
3.) What grade are you in?
9
10
11
12
13+
4.) How many subjects are you currently taking?
1
2
3
4
5
5.) What type of subjects are you currently taking?
Math
Science
Social Sciences
Arts
English
Physical Education
Business
Other
6.) If you receive homework, how many hours a week do you spend on homework?
0
1-2
3-4
5-6
7-8
9-10
11+
7.) If yes to previous question do you find yourself spending more time on homework than doing activities you enjoy?
Yes
No
Sometimes
8.) Are you currently employed? (If No please skip to question 12)
Yes
No
9.) What line of work are you in currently in?
10) On average how many hours do you work a week?
0-5
6-10
11-15
16-20
21-25
26-30
31-35
36-40
41+
11.) On a scale of 1-10 how happy are you at your job?
1
2
3
4
5
6
7
8
9
10
12.) Do you currently participate in any extracurricular activities? (If No please skip to question 16)
Yes
No
13.) What type of extracurricular activities do you participate in?
Sports/Fitness
Music
Art
Other
14.) On average how many hours do you put into extracurricular activities a week?
0-5
6-10
11-15
16-20
21-25
26-30
31-35
36-40
41+
15.) On a scale of 1-10 how much do you enjoy these activities?
1
2
3
4
5
6
7
8
9
10
16.) Do you normally get the full 3 meals a day? (Breakfast, Lunch and Dinner)
Yes
No
Sometimes
17.) Would you say you have stress in your life?
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
18.) If yes to previous question how would you rate your stress level in your life right now?
0 being no stress at all
1-2
3-4
5-6
7-8
9-10
11+ being the most stress you have ever felt
19.) If the following question applies where would you rank the stress factors in your life?
School
Work
Extracurricular actives
20.) Do you currently have a home to live in?
Yes
No
21.) If you do have a home what type of home do you live in?
Detached home
Town house
Apartment
Other
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