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© 2015 Janet E Lapp PhD ChangeFit info@Changefit.org
How are you doing?
This survey is based on validated Burnout Assessments but
has been “watered down” and simplified. However, you’ll
still get a good reading of how your self-care is going, and
what, if any, changes you need to make.
Read the statements. If you can agree, give yourself the
number of points shown. Be real, nobody but you will see
your answers.
© 2015 Janet E Lapp PhD ChangeFit
© 2015 Janet E Lapp PhD ChangeFit info@Changefit.org
Questions are grouped into three zones:
Green.
Orange.
Red.
© 2015 Janet E Lapp PhD ChangeFit info@Changefit.org
1 You feel guilty about
those unread magazines
and newspapers.
1 You wish you had a week
others didn’t have, just
to catch up.
How are you doing?
© 2015 Janet E Lapp PhD ChangeFit info@Changefit.org
1 You nod your head knowingly when
people mention a news story or book of
which you’ve never heard.
© 2015 Janet E Lapp PhD ChangeFit info@Changefit.org
1 You get to work earlier and stay
later.
1 You feel a bit scattered and
overwhelmed.
1 You’re more forgetful than you
used to be.
© 2015 Janet E Lapp PhD ChangeFit info@Changefit.org
2 You haven’t been to the gym for
awhile, but you’ll get back to it soon.
Really.
2 Your spouse or kids tell you they need
more time with you. You say “I’m busy
right now, honey.”
© 2015 Janet E Lapp PhD ChangeFit info@Changefit.org
2 Your friends are on hold. You’ll connect
later, when the crunch is over.
2 You can’t remember the last time you
worked on a hobby.
© 2015 Janet E Lapp PhD ChangeFit info@Changefit.org
2 You are more irritable and IMPATIENT.
2 Your neck and shoulders are bothering
you. Sometimes your eye twitches.
2 A cold lingers on longer than usual.
© 2015 Janet E Lapp PhD ChangeFit info@Changefit.org
3 Things aren’t much fun.
3 Some days you don’t even
want to get up.
5 You don’t even have the energy to
add up these points.
© 2015 Janet E Lapp PhD ChangeFit info@Changefit.org
Questions are grouped into three zones:
Green - doing OK, stressed a bit but coping ok. You’re trying to do
too much with old strategies and they're not working as well as
you’d like. Score is out of 6.
Orange - you’ve started to make lifestyle changes based on your
workload and narrowing focus. You are in danger at this point. If
you continue on this path, you will find yourself getting sick. The
condition doesn’t fix itself. Score out of 14.
Red - Your score indicates burnout. You need immediate self-
healing, nurturing. Maybe a few days off to regroup. Rethink
everything you do. Refocus, get some help. Out of 11.
© 2015 Janet E Lapp PhD ChangeFit info@Changefit.org
How are you doing?
Say the total possible score is 31. There is no absolute demarcation;
as you guessed, it’s all relative.
If you scored under 6, carry on.
Between 7 and say 18, pay attention and make changes.
Over 18, don’t panic. Burning out means you care a great deal, you
just don’t know when to turn it off. A lot of us are missing this
switch. Do less, start to add activities you’ve dropped, get some
nurturing.
You’ll be more useful than you are now.
© 2015 Janet E Lapp PhD ChangeFit

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Balanced or Burned Out? Check in here.

  • 1. © 2015 Janet E Lapp PhD ChangeFit info@Changefit.org How are you doing? This survey is based on validated Burnout Assessments but has been “watered down” and simplified. However, you’ll still get a good reading of how your self-care is going, and what, if any, changes you need to make. Read the statements. If you can agree, give yourself the number of points shown. Be real, nobody but you will see your answers. © 2015 Janet E Lapp PhD ChangeFit
  • 2. © 2015 Janet E Lapp PhD ChangeFit info@Changefit.org Questions are grouped into three zones: Green. Orange. Red.
  • 3. © 2015 Janet E Lapp PhD ChangeFit info@Changefit.org 1 You feel guilty about those unread magazines and newspapers. 1 You wish you had a week others didn’t have, just to catch up. How are you doing?
  • 4. © 2015 Janet E Lapp PhD ChangeFit info@Changefit.org 1 You nod your head knowingly when people mention a news story or book of which you’ve never heard.
  • 5. © 2015 Janet E Lapp PhD ChangeFit info@Changefit.org 1 You get to work earlier and stay later. 1 You feel a bit scattered and overwhelmed. 1 You’re more forgetful than you used to be.
  • 6. © 2015 Janet E Lapp PhD ChangeFit info@Changefit.org 2 You haven’t been to the gym for awhile, but you’ll get back to it soon. Really. 2 Your spouse or kids tell you they need more time with you. You say “I’m busy right now, honey.”
  • 7. © 2015 Janet E Lapp PhD ChangeFit info@Changefit.org 2 Your friends are on hold. You’ll connect later, when the crunch is over. 2 You can’t remember the last time you worked on a hobby.
  • 8. © 2015 Janet E Lapp PhD ChangeFit info@Changefit.org 2 You are more irritable and IMPATIENT. 2 Your neck and shoulders are bothering you. Sometimes your eye twitches. 2 A cold lingers on longer than usual.
  • 9. © 2015 Janet E Lapp PhD ChangeFit info@Changefit.org 3 Things aren’t much fun. 3 Some days you don’t even want to get up. 5 You don’t even have the energy to add up these points.
  • 10. © 2015 Janet E Lapp PhD ChangeFit info@Changefit.org Questions are grouped into three zones: Green - doing OK, stressed a bit but coping ok. You’re trying to do too much with old strategies and they're not working as well as you’d like. Score is out of 6. Orange - you’ve started to make lifestyle changes based on your workload and narrowing focus. You are in danger at this point. If you continue on this path, you will find yourself getting sick. The condition doesn’t fix itself. Score out of 14. Red - Your score indicates burnout. You need immediate self- healing, nurturing. Maybe a few days off to regroup. Rethink everything you do. Refocus, get some help. Out of 11.
  • 11. © 2015 Janet E Lapp PhD ChangeFit info@Changefit.org How are you doing? Say the total possible score is 31. There is no absolute demarcation; as you guessed, it’s all relative. If you scored under 6, carry on. Between 7 and say 18, pay attention and make changes. Over 18, don’t panic. Burning out means you care a great deal, you just don’t know when to turn it off. A lot of us are missing this switch. Do less, start to add activities you’ve dropped, get some nurturing. You’ll be more useful than you are now. © 2015 Janet E Lapp PhD ChangeFit