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Mental Health and Wellness Questionnaire
1.
How have you been feeling in the past week?
*
1.
How often do you experience stress?
(Required.)
Rarely
Sometimes
Often
Always
*
2.
What are your coping mechanisms for stress?
(Required.)
*
3.
Do you feel overwhelmed by your emotions?
(Required.)
Always
Usually
Sometimes
Rarely
Never
*
4.
How do you manage your emotions?
(Required.)
*
5.
Do you prioritize self-care activities? (
reading, drawing, etc
)
(Required.)
A great deal
A lot
A moderate amount
A little
None at all
*
6.
What self-care activities do you engage in?
(Required.)
*
7.
In a typical week, how often do you feel stressed at work?
(Required.)
Always
Most of the time
About half of the time
Once in a while
Never
*
8.
Have you ever used any formal mental health related services? (For example, receiving counseling, guidance, or help with something in your life from a professional or semi-professional provider.)
(Required.)
Yes
No
*
9.
In general, how would you rate your overall mental or emotional health?
(Required.)
Excellent
Very good
Good
Fair
Poor
*
10.
How would you rate your overall mental well-being?
(Required.)
Excellent
Good
Fair
Poor
Current Progress,
0 of 10 answered