31
Questions for each episode
|
This is episode number......., which b |
egan at.............and ended at......... |
... . | |
|
8. Were you interacting with am 0) No one □ |
rone during the episode, and if y in person on the phone EmailZChat |
es, how? Please also intense quick | |
|
1) SpoiiseZpartner □ |
□ □ □ |
□ |
□ |
|
2) your cluldreii □ (under age 10) 3) parents/ |
□ □ □ |
□ |
□ |
|
relatives □ |
□ □ □ |
□ |
□ |
|
4) Iriends □ |
□ □ □ |
□ |
□ |
|
5) co-workers □ |
□ □ □ |
□ |
□ |
|
6) ClientsZcustomers □ |
□ □ □ |
□ |
□ |
|
7) boss □ |
□ □ □ |
□ |
□ |
|
8) Other people (___________) □ Please specify! 9. How satisfied were you during Not at all 0 12 3 4 10. How did you feel during this ep |
□ □ □ his episode? ==□^=□^=□^=□-□= ɪsode? |
□ L Very much =□ 10 | |
|
Please rate each feeling on the scale given. A rating of 0 means that you did not experience that feeling at all. | |||
|
A rating of 10 means dial this feeling was a very important part of the experience. Please check the Iiiunber that Not at all Very much | |||
|
0 ɪ 2 |
3 4 5 6 7 |
S |
9______10 |
|
IethargicZdull □ □ □ |
□ □ □ □ □ |
□ |
□ □ |
|
enjoying myself □ □ □ |
□ □ □ □ □ |
□ |
□ □ |
|
insecure/anxious □ □ □ |
□ □ □ □ □ |
□ |
□ □ |
|
happy □ □ □ |
□ □ □ □ □ |
□ |
□ □ |
|
IrustratedZamioyed □ □ □ |
□ □ □ □ □ |
□ |
□ □ |
|
relaxed □ □ □ |
□ □ □ □ □ |
□ |
□ □ |
|
stressed □ □ □ |
□ □ □ □ □ |
□ |
□ □ |
|
CoinfortableZat ease □ □ □ |
□ □ □ □ □ |
□ |
□ □ |