Mood Tracking Form

Mood Tracking Form
Name/Nickname

First NameLast Name
Gender
1) How do you feel right now?

HappyAngrySadStressedAnxiousFrustratedCalmOther
1) On a scale of 1 to 5 how intense is the above feeling?

1

2

3

4

5

1 is Bad, 5 is Good
3) Which color make you feel more negative right now?

PopHiphop/RapRockElectronic/DanceJazzR&B/SoulClassicalCountryAcoustic/FolkOther
How Often You Experience the Moods
5) Rate your Happiness Level

1

2

3

4

5

1 is Never, 5 is Constantly
6) Rate your Sadness Level

1

2

3

4

5

1 is Never, 5 is Constantly
7) Rate your Rage Level

1

2

3

4

5

1 is Never, 5 is Constantly
8) Rate your Boredom Level

1

2

3

4

5

1 is Never, 5 is Constantly
9) What makes you happy? Please list them all.
9) What makes you happy? Please list them all.
10) What causes you to be sad? Please list them all.
11) What annoys you? Please list them all.
Do you have any further thoughts?
Should be Empty:

How Often You Experience the Moods