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Worksheet

Burnout Awareness Scorecard: Track Your Stress and Well-being

Description: This scorecard allows you to regularly assess your stress levels and overall well-being. It provides a structured way to track progress and make necessary adjustments to your routines. 

Instructions: 

  1. Weekly Scoring: Rate each category on a scale from 1 to 5 (1 = Very Poor, 5 = Excellent). 
  1. Reflection: At the end of each week, reflect on your scores and identify any patterns or areas of concern. 
  1. Action Steps: Write down at least one action step to improve any area with a score of 3 or lower. 
1. ➜

Section 1: Physical Health

Sleep Quality: Rate your sleep quality over the past week. 

2. ➜

Section 1: Physical Health

Energy Levels: Rate your overall energy levels. 

3. ➜

Section 1: Physical Health

Physical Symptoms: Rate the frequency of physical symptoms such as headaches, illnesses, or chronic fatigue. 

4. ➜

Reflection: 

What patterns do you notice in your physical health scores? 

5. ➜

Action Step: 

What can you do to improve your physical health next week? 

6. ➜

Section 2: Emotional Health

Mood: Rate your overall mood over the past week. 

7. ➜

Section 2: Emotional Health

Stress Levels: Rate your stress levels.

8. ➜

Section 2: Emotional Health

Emotional Symptoms: Rate the frequency of emotional symptoms such as anxiety or irritability. 

9. ➜

Reflection: 

What patterns do you notice in your emotional health scores?

10. ➜

Action Step: 

What can you do to improve your emotional health next week? 

11. ➜

Section 3: Behavioral Changes

Social Interactions: Rate the quality and frequency of your social interactions. 

12. ➜

Section 3: Behavioral Changes

Work Performance: Rate your work performance. 

13. ➜

Section 3: Behavioral Changes

Procrastination: Rate your tendency to procrastinate. 

14. ➜

Reflection: 

What patterns do you notice in your behavioral changes scores? 

15. ➜

Action Step: 

What can you do to improve your behaviors next week? 

16. ➜

Section 4: Self-Care Activities

Exercise: Rate your frequency and quality of exercise. 

17. ➜

Section 4: Self-Care Activities

Meditation: Rate your frequency and quality of meditation or mindfulness practices. 

18. ➜

Section 4: Self-Care Activities

Hobbies: Rate the time spent on hobbies and activities you enjoy.

19. ➜

Reflection: 

What patterns do you notice in your self-care activities scores? 

20. ➜

Action Step: 

What can you do to improve your self-care activities next week? 

21. ➜

Usage


  1. Fill out the scorecard weekly: Review your scores to identify trends. 
  2. Reflect on your scores: Note any patterns or areas of concern. 
  3. Set action steps: Write down specific actions to improve areas with low scores. 
  4. Track progress: Use the scorecard consistently to monitor your well-being over time. 

By regularly assessing your stress levels and well-being, you can take proactive steps to manage and prevent burnout. Remember, self-care is not a luxury; it's a necessity. 

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