Burnout Assessment Tool This questionnaire is useful as a self-assessment to see if you are at risk of burnout. It is, however, not meant to be used for diagnosis of any illness or condition, and it should not replace a formal consultation with a healthcare professional. Providing your name and email address on this self-assessment is completely optional. Any information you share will not be used without your permission. If you would like us to reach out to schedule an appointment for a formal consultation, please use our Contact Form instead to ensure your request is properly received. Your privacy and confidentiality are important to us. The following statements are related to your work situation and how you experience your work situation. Please state how often each statement applies to you. Name Email Address At work, I feel mentally exhausted Please select your answer Never Rarely Sometimes Often Always After a day at work, I find it hard to recover my energy Please select your answer Never Rarely Sometimes Often Always At work, I feel physically exhausted Please select your answer Never Rarely Sometimes Often Always I struggle to find any enthusiasm for my work Please select your answer Never Rarely Sometimes Often Always I feel a strong aversion towards my job Please select your answer Never Rarely Sometimes Often Always I’m cynical about what my work means to others Please select your answer Never Rarely Sometimes Often Always At work, I have trouble staying focused Please select your answer Never Rarely Sometimes Often Always I make mistakes in my work because I have my mind on other things Please select your answer Never Rarely Sometimes Often Always When I’m working, I have trouble concentrating Please select your answer Never Rarely Sometimes Often Always At work, I feel unable to control my emotions Please select your answer Never Rarely Sometimes Often Always I do not recognize myself in the way I react emotionally at work Please select your answer Never Rarely Sometimes Often Always At work I may overreact unintentionally Please select your answer Never Rarely Sometimes Often Always Time's up
