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Teen Stress Survey Form Template

Understanding the pressures teens face with this simple survey

Feeling overwhelmed by stress is common among teens, and identifying these pressures can be the first step toward positive change. This Teen Stress Survey Form Template helps educators, parents, and counselors gather valuable insights into what teenagers are dealing with daily. You can effectively gauge stress levels, discover key issues affecting their well-being, and facilitate conversations that matter, all while ensuring compliance with privacy standards. Start utilizing this live template to foster healthier support systems for teens.

Use this Template (FREE) Live Preview
Do you want to take this survey now?
Yes
No
How old are you?
Under 18
18-24
25-34
35-44
45-54
55-64
65+
Prefer not to say
What is your current grade or year in school?
What is your gender?
Woman
Man
Non-binary
Prefer to self-describe
Prefer not to say
Overall, how stressed have you felt in the past 7 days?
Not at all
A little
Somewhat
Quite a bit
Extremely
Prefer not to say
In the past 7 days, how often did you feel nervous, anxious, or on edge?
Very rarely
Rarely
Sometimes
Often
Very often
How often did stress make it hard to pay attention at school or while studying?
Very rarely
Rarely
Sometimes
Often
Very often
On school nights, how many hours of sleep do you usually get?
Less than 5 hours
5-6 hours
6-7 hours
7-8 hours
8-9 hours
More than 9 hours
Prefer not to say
What are your biggest current sources of stress? (Select all that apply)
Please Specify:
If you want to share more about your stress or what causes it, you can write here (optional).
Where do you usually notice stress in your body or feelings? (Select all that apply)
Please Specify:
Which things do you do to cope with stress? (Select all that apply)
Please Specify:
How satisfied are you with your current ways of coping?
Very dissatisfied
Dissatisfied
Neutral
Satisfied
Very satisfied
I can manage my stress in healthy ways.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
If needed, how likely are you to ask for help from a counselor or mental health professional?
Very unlikely
Unlikely
Neutral
Likely
Very likely
In the past two weeks, have you had thoughts of harming yourself?
Yes
No
Prefer not to say
If there is anything you want adults to know to help keep you safe, you can share here (optional).
In the past two weeks, have you felt unsafe at school or online?
Yes
No
Prefer not to say
Your name (optional)
Email (optional)
Phone number (optional)
Would you like someone to follow up with you?
Yes
No
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Paper art illustration depicting a teen stress survey form design with creative elements and vibrant colors

When to use this form

You can use this survey at the start of a term, before exams, or after a major event (remote learning shift, bullying report, school move). It helps counselors, teachers, and youth program staff spot stress early and prioritize outreach. Use it during intake for new students, as a mid-year check-in, or in advisory when you see slipping grades, absences, or mood changes. Pair findings with the Student perception survey form to understand climate issues that may fuel anxiety, and the Student motivation survey form to see how stress affects effort. If you want to connect supports to outcomes, review patterns next to the Course completion form. The result is a clear list of stressors, risk flags, and next steps you can act on quickly.

Must Ask Teen Stress Survey Questions

  1. In the past two weeks, how often have you felt stressed or overwhelmed?

    A short time frame reduces recall bias and shows current risk. Frequency helps you triage who needs immediate support versus routine check-ins.

  2. What are the top three sources of stress for you right now?

    This pinpoints triggers so you can tailor actions, like schedule changes, social support, or family outreach. It also reveals patterns across students to inform schoolwide steps.

  3. How is stress affecting your sleep, mood, concentration, or attendance?

    Impact areas indicate severity and where to intervene (sleep hygiene, counseling, study skills, attendance plan). Linking effects to academics makes it easier to measure progress over time.

  4. Who do you feel comfortable talking to when you feel stressed?

    Knowing trusted adults or peers lets you activate a support network quickly. If a student lists no one, plan proactive outreach and safe check-in options.

  5. What support would help you most in the next month?

    Letting students choose supports creates buy-in and clearer next steps. If classroom changes or accommodations are needed, coordinate with the Teacher input for IEP form.

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