Spirituality Assessment
Name
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First Name
Last Name
Date
*
1. What is your spiritual belief system?
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2. Is there any particular practice that helps you deal with things outside of your control? If yes, please specify.
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3. Do you believe that spirituality can affect your mental health?
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Yes
No
Maybe
4. How important from 1 to 10 (10 being very important and 1 being not important at all) is spirituality for you?
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Thank you!
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