Burnout Rating Scale Think over the past 3 months and score the following questions according to how often you have experienced these symptoms. 0=Never 1=Very rarely 2=Rarely 3=Sometimes 4=Often 5=Very often 1. Do you feel fatigued in a way that rest or sleep does not releive? Never Very rarely Rarely Sometimes Often Very often 2. Do you feel more cynical, pessimistic or dillusional about things you used to feel positive about? Never Very rarely Rarely Sometimes Often Very often 3. Do you feel sadness or emptiness inside? Never Very rarely Rarely Sometimes Often Very often 4. Do you have physical symptoms of stress, eg. insomnia, stomach pain, headaches, migranes? Never Very rarely Rarely Sometimes Often Very often 5. Is your memory unreliable? Never Very rarely Rarely Sometimes Often Very often 6. Are you irritable or emotional with a short fuse? Never Very rarely Rarely Sometimes Often Very often 7. Have you been more suseptible to illness lately, eg. colds, flu, food, allegies, hay fever? Never Very rarely Rarely Sometimes Often Very often 8. Do you feel like isolating yourself from colleagues, friends or family? Never Very rarely Rarely Sometimes Often Very often 9. Is it hard to enjoy yourself, have fun, relax and experience joy in your life? Never Very rarely Rarely Sometimes Often Very often 10. Do you feel that you are accomplishing less in your work? Never Very rarely Rarely Sometimes Often Very often My Score:Date MM slash DD slash YYYY OtherOther indicators of being over stressed or approaching burnout for me are: Score of 0 -15: You are doing well. Score of 16 - 25: Some attention needed, you may be a candidate. Warning!Score above 25 you may be a candidate. More informationPlease "take a knee" if you feel you might need to!NameThis field is for validation purposes and should be left unchanged. Δ
