Please Participate in the Occupational Stress Survey

Your Inputs and Perspectives Can Make a Significant Difference

The Occupational Stress Survey focuses upon two main occupational areas: Law Enforcement / First Responders and members of our Military. While the military missions differ from the general category of first responders, they do in fact respond (from a global perspective) and their stress result have similarities.  This is a short survey that should take no more than five to ten minutes to complete.

Please know that your responses can make a significant difference in the lives of those that serve our nation.  Thank you.

All responses to this survey are COMPLETELY ANONYMOUS.

The Survey begins below.

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1. Sex *

Male

Female

2. Marital Status *

Single

Engaged

Married

In a Long-Term Relationship

Separated

Divorced

Widow / Widower

3. Age Range *

18-24

25-34

35-44

45-54

55-64

65 or Above

4. Occupational Sector *

Law Enforcement / First Response

Military

Law Enforcement / First Response

911 or other Dispatch Operators

Emergency Medical Services

Fire Fighter

Law Enforcement

Other (note below)

First Response / Military (Other)

Work Environment

5. How many hours do you typically work per week? *

Less than 40 hours per week

40 to 50 hours per week

50 to 60 hours per week

More than 60 hours per week

6. How would you rate your job satisfaction? *

Very Satisfied

Satisfied

Neutral

Unsatisfied

Very Unsatisfied

7. How would you rate your income level? *

Under Paid

Sufficiently Paid

Paid Well

8. Do you feel that you receive adequate training to stay current in your position? *

Yes

No

9. Do you feel your organization has enough resources necessary to be effective? *

Yes

No

10. Is your organization properly staffed with personnel to be effective? *

Yes

No

11. How would you rate support from supervisory staff? *

Very Satisfied

Satisfied

Neutral

Unsatisfied

Very Unsatisfied

12. How would you rate health, wellness or counseling assistance in your organization? *

Very Satisfied

Satisfied

Neutral

Unsatisfied

Very Unsatisfied

N/A

13. If resources are available, what is of most value?

14. If resources are lacking, what is needed most?

15. If a stress management program or resources were offered to your organization, what office would they contact? (Office name) *

16. How much does YOUR OWN PERSONAL EXPECTATIONS impact your ability to be efficient in your job? *

Low

Moderate

High

N/A

17. How much does PUBLIC EXPECTATIONS impact your ability to be efficient in your job? *

Low

Moderate

High

N/A

Lifestyle:

18. How many hours do you typically sleep per night? *

19. Do you smoke? *

Yes

No

Describe your level of smoking

Light

Moderate

Heavy

20. Do you drink alcohol? *

Yes

No

Describe your alcohol use

Light

Moderate

Heavy

21. Do you use marijuana, designer drugs or other drugs? *

Yes

No

If Yes, Provide details:

22. Are you happy with your weight? *

Yes

No

23. How is your overall health compared to one-year ago? *

Worse than last year

About the same as last year

Better than last year

24. Do you exercise regularly? *

Yes

No

Feelings and Self Perception

25. How would you rate your stress level? *

Low

Moderate

High

26. How would you rate your overall self confidence? *

Low

I'm doing Okay

I'm feeling great about myself

27. How would you rate your confidence level compared to one-year ago? *

Lower confidence

About the same as last year

Higher Confidence

28. Do you find yourself replaying in your mind past hurts or disappointments? *

Yes

No

29. Do you worry about the future? *

Yes

No

If so, what causes you to worry?

Maintaining a job

Health concerns

Family issues

Dangers on the job

Global economy

Natural disasters

Crime or violence in society

Global wartime situations

Terrorism

Other (describe)

30. Have you had a family member, friend, neighbor or co-worker who has been seriously ill, injured or died (from illness) during the last year? *

Yes

No

If so, how did that illness, injury or death impact you?

No Impact

Little Impact

Moderate Impact

Significant Impact

31. Have you had a family member, friend, neighbor or co-worker who died from accident, violence or suicide during the last year? *

Yes

No

If so, how that death or suicide impact you?

No Impact

Low Impact

Moderate Impact

Significant Impact

32. Have you at any time during the last 3-years consider harming yourself? *

Yes

No

If so, did you seek help?

Yes

No

If you sought help, where did you go?

Friend

Relative

Important Personal Relationship

Clergy or other Religious Person

Doctor

Therapist

Employer

Help Hotline

Other (Provide details below)

Other:

33. In the last 3-years, have you ever considered harming someone else? *

Yes

No

Did you seek help?

Yes

No

Where did you go for help?

Friend

Relative

Important Personal Relationship

Clergy or other Religious Person

Doctor

Therapist

Employer

Help Hotline

Other (Provide details below)

Other:

34. If you experienced one of these stressful events (noted above) during the last 3-years and sought help, did you receive the help you needed?

Yes

No

35. If you experienced one of the stressful events (noted above) during the last 3-years and you chose NOT to seek help, what prevented you from reaching out?

36. If you would like to add additional comments, please add them here.

If you are human, leave this field blank.

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