EMOTIONAL HEALTH ASSESSMENT QUESTIONNAIRE

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I FEEL STRESSED OUT

 
 
 
 

I AM ON MEDICATIONS FOR HEALTH PROBLEMS

 
 
 
 

I SUFFER FROM POOR SLEEP

 
 
 
 

I EXPERIENCE FATIGUE, BODY ACHE OR SOME OTHER HEALTH PROBLEMS

 
 
 
 

I FIND MYSELF LOW IN ENERGY

 
 
 
 

I FIND MYSELF DEMOTIVATED AND LACKING IN ENTHUSIASM

 
 
 
 

I EXPERIENCE PROBLEMS IN RELATIONS

 
 
 
 

I FIND MYSELF ADDICTED TO FOOD, SWEETS, TV OR MOBILE

 
 
 
 

I FIND MYSELF ADDICTED TO ALCOHOL, DRUGS, OR PORN

 
 
 
 

I STRUGGLE TO FOCUS ON THE TASK AT HAND?

 
 
 
 

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