Caring for someone with a serious illness can be stressful. Maintaining your health and wellness during this time is important. Families are often unprepared to deal with patients’ symptoms and illness.

The following questionnaire is designed as a self-assessment that will assess your risk factors for poor health and well-being during this time.

Please complete every question. At the end you will receive your self-assessment score. All the information you provide will be kept confidential.

Adjusting to the loss of someone close can be very difficult and sometimes families need help during this adjustment process.

The following questionnaire is a self-assessment designed to let you know if you are at risk of having a difficult adjustment to the loss of someone close.

Please answer every question. At the end you will receive your self-assessment score. All the information you provide will be kept confidential.