Rebecca Marie
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Question of
Do you ever work more hours in a week than you plan to work?
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Never
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Rarely
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Sometimes
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Often
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Very Often
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Question of
Do you feel moody, guilty, anxious when you are not working?
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Never
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Rarely
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Sometimes
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Often
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Very Often
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Question of
When you aren’t at work, do you spend large amounts of time checking your work email or phone, or thinking about work you’ve yet to finish?
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Never
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Rarely
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Sometimes
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Often
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Very Often
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Question of
Do you plan to reduce your work hours with little success?
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Never
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Rarely
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Sometimes
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Often
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Very Often
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Question of
Does work ever negatively affect your relationships?
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Never
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Rarely
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Sometimes
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Often
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Very Often
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Question of
Has work ever kept you from getting a healthy amount of sleep?
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Never
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Rarely
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Sometimes
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Often
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Very Often
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Question of
Has work ever interfered with your health?
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Never
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Rarely
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Sometimes
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Often
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Very Often
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Question of
Do you not take vacation or sick days in order to complete more work?
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Never
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Rarely
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Sometimes
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Often
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Very Often
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Question of
Do you find it difficult to concentrate on conversations or other tasks when you’re not working?
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Never
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Rarely
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Sometimes
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Often
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Very Often
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Question of
Do you hide how much you work to loved ones?
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Never
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Rarely
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Sometimes
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Often
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Very Often
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Comments
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