Count the number of conditions that you have
experienced in the past two weeks.

___  I often feel shaky.
___  I have muscle tension.
___  I feel restless.
___  I am experiencing fatigue.
___  I have shortness of breath.
___  I experience palpitations or accelerated heart rate.
___  I have sweaty or cold, clammy hands.
___  I experience dry mouth.
___  I feel dizzy or lightheaded.
___  I experience or abdominal distress
.
___  I have hot flashes or chills.
___  I experience frequent urination.
___  I feel keyed up or on edge.
___  I get startled easily.
___  My mind goes blank and I can’t concentrate.
___  I have trouble falling or staying asleep.
___  I feel irritable.
___  I obsess over my worries.
___  I have racing thoughts.

If you have at least six of the above symptoms, brief therapy
can help you to identify the sources of your stress, acquire
the tools to become stress resilient, and restore your
physiological equilibrium. If you have experienced these for
more than a year, you are placing yourself in danger of
serious medical complications and need an immediate
consult with a therapist, and possibly a primary care
physician.

Please note the following that apply to you:
I would like to:

___  increase my sense of wellbeing and happiness.
___  have more peace of mind.
___  have more energy throughout the day.
___  attain more balance in my life.
___  experience fewer headaches
___  have more success in my weight loss program.
___  finally complete a project or goal

If you are interested in any of the above goals, than you are a
good candidate for working with a coach. A coach can help
you determine a plan to take you from where you are now to
where you want to be.
If you are interested in both therapy and coaching, it is
advisable to pursue therapy prior to coaching. When you
have less anxiety, you are in a better position to actualize
your coaching goals.



                             Teresa Trower M.A. LMHC
                          (904) 260-1486
                             trowerteresa@yahoo.com
Stress Survey

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