info@hcfstx.org         830.249.8643

Financial Stress Survey

Name(Required)

The following statements are used to measure financial stress. Please mark how strongly you agree or disagree with each statement based on the following 5-point scale: 1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree

Financial Anxiety:


Please mark the box that best describes how you feel at this time. 1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree

I feel anxious about my financial situation.(Required)
I have difficulty sleeping because of my financial situation.(Required)
I have difficulty concentrating on my school or work because of my financial situation.(Required)
I am irritable because of my financial situation.(Required)
I find it difficult to control worrying about my financial situation.(Required)
I experience muscle tension because of worrying about my financial situation.(Required)
I feel fatigued because I worry about my financial situation.(Required)

Job Insecurity:


Please mark the box that best describes how you feel at this time. 1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree

I am worried about having to leave my job before I would like to.(Required)
There is a risk that I will have to leave my current job within the coming year.(Required)
I feel uneasy about losing my job in the near future.(Required)
My future career opportunities with my employer are favorable.(Required)
I feel that my employer can provide me with challenging work in the near future.(Required)
My pay development in my current employment is promising.(Required)

Life Satisfaction:


Please mark the box that best describes how you feel at this time. 1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree

In most ways my life is close to my ideal.(Required)
The conditions of my life are excellent.(Required)
I am satisfied with my life.(Required)
So far I have achieved the important things I want in life.(Required)
If I could live my life over, I would change almost nothing.(Required)

Financial Well-Being:


Please mark the box that best describes how you feel at this time. 1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree

I could handle a major unexpected expense.(Required)
I am securing my financial future.(Required)
Because of my money situation, I feel like I will never have the things I want in life.(Required)
I can enjoy life because of the way I am managing my money.(Required)
I am just getting by financially.(Required)
I am concerned that the money I have or will have won't last.(Required)
Giving a gift for a wedding, birthday or other occasion would put a strain on my finances for the month.(Required)
I have money left over at the end of the month.(Required)
I am behind with my finances.(Required)
My finances control my life.(Required)

Negative Feelings:


Please mark the box that best describes how you feel at this time. 1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree

Afraid(Required)
Distressed(Required)
Nervous(Required)
Scared(Required)
Upset(Required)
Name

SUBSCRIBE TO

OUR NEWSLETTER