This document contains a burnout questionnaire to assess levels of burnout. It includes 21 questions to rate frequency of experiences on a scale of 1 to 7. Scores between 2-3 indicate doing well, 3-4 means examine work life, over 4 requires action, and over 5 needs immediate help. The document provides guidance on interpreting burnout scores.

1. Your Burn Out Meter!!!
How Often do you experience any of the following situations?
Please use the following Scale Never 1
Once in agreat while 2
Rarely 3
Compute your burnout score by completing the following
Sometimes 4
questionnaire using the scale provided on the top right.
Often 5
Usually 6
1 Being Tired Always 7
2 Feeling Depressed
3 Having a good day
4 Being Physically exhausted
5 Being emotionally exhausted
6 Being Happy Your Burn-Out Score
7 Being quot;Wiped Outquot;
8 quot;Can't take it anymore
9 Being unhappy 7.0
10 Feeling run-down
6.0
11 Feeling trapped
12 Feeling worthless 5.0
13 Being Weary
4.0
14 Being troubled
15 Feeling disilliusioned & resentful 3.0
16 Being weak & susceptible to illness
2.0
17 Feeling hopeless
18 Feeling rejected 1.0
19 Feeling Optimistic
0.0
20 Feeling Energetic
21 Feeling Anxious
More about your Score:
If your Score between 2 & 3, you are doing well. The only suggestion we make is that you go
over your score sheet to be sure you have been honest in your responses.
If your score is between 3 & 4, it would be wise for you to examine your work life, evaluate your
priorities and consider possible changes.
If your score is higher than 4, you are experiencing burnout to the extent that it is mandatory that
you do something about it.
A score of higher than 5 indicates an acute state and a need for immediate help.
* Adapted from Ayala Pines, Ph.D. and Elliot Aronson, Ph.D., quot; Why Managers Burn Out,quot; Sales & marketing
management 4 (February 1989):38.

2. Your Burn Out Meter!!!
* Adapted from Ayala Pines, Ph.D. and Elliot Aronson, Ph.D., quot; Why Managers Burn Out,quot; Sales & marketing
management 4 (February 1989):38.