Mental Wellbeing Survey
Please indicate your age & gender
Please tick the box that best described your experience of each over the last 2 weeks.
*
None of the time
Rarely
Some of the time
Often
All of the time
I've been feeling optimistic about the future
I've been feeling useful
I've been feeling relaxed
I've been feeling interested in other people
I've had energy to spare
I've been dealing with problems well
I've been thinking clearly
I've been feeling good about myself
I've been feeling close to other people
I've been feeling confident
I've been able to make up my own mind about things
I've been feeling loved
I've been interested in new things
I've been feeling cheerful
I would like to be contacted regarding my results and options.
*
Yes, I would.
No, I would not.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
example@example.com
Submit
Should be Empty: