Self-Assessment

Burnout Self-Assessment

"*" indicates required fields

Progress

7%

Your name*

Carefully read the following statements and select the option that best describes how much you agree with the statement. Select ‘Next’ to start…

Personal burnout

How often do you feel tired?*

Never/Almost Never

Seldom

Sometimes

Often

Always

How often are you physically exhausted?*

Never/Almost Never

Seldom

Sometimes

Often

Always

How often are you emotionally exhausted?*

Never/Almost Never

Seldom

Sometimes

Often

Always

How often do you think: “I can’t take it anymore”?*

Never/Almost Never

Seldom

Sometimes

Often

Always

How often do you feel worn out?*

Never/Almost Never

Seldom

Sometimes

Often

Always

How often do you feel weak and susceptible to illness?*

Never/Almost Never

Seldom

Sometimes

Often

Always

Work-related burnout

Do you feel worn out at the end of the working day?*

Never/Almost Never

Seldom

Sometimes

Often

Always

Are you exhausted in the morning at the thought of another day at work?*

Never/Almost Never

Seldom

Sometimes

Often

Always

Do you feel that every working hour is tiring for you?*

Never/Almost Never

Seldom

Sometimes

Often

Always

Do you have enough energy for family and friends during leisure time?*

To a very low degree

To a low degree

Somewhat

To a high degree

To a very high degree

Is your work emotionally exhausting?*

To a very low degree

To a low degree

Somewhat

To a high degree

To a very high degree

Does your work frustrate you?*

To a very low degree

To a low degree

Somewhat

To a high degree

To a very high degree

Do you feel burnout out because of your work?*

To a very low degree

To a low degree

Somewhat

To a high degree

To a very high degree

This field is hidden when viewing the form

screening_score

This field is hidden when viewing the form

screening_score_2

This field is hidden when viewing the form

screening_position

This field is hidden when viewing the form

screening_completed

This field is hidden when viewing the form

screening_score_level_1

This field is hidden when viewing the form

screening_score_level_2

This field is hidden when viewing the form

screening_score_level_message_1

This field is hidden when viewing the form

screening_score_level_message_2

Comments

This field is for validation purposes and should be left unchanged.

← Back to self-assessments

@ Copyright 2025 Transitioning Well | Privacy Policy

Notifications