WHO-5 Index
World Health Organization Well-Being Index
Participant Name
*
First Name
Last Name
Date of Birth (DOB)
*
Participant DOB
One Box Per Row Re: How You've Been Feeling Over Last Two Weeks
*
Rows
Always
Mostly
More Than Half
Less Than Half
Never
Cheerful/Good Spirits
Calm & Relaxed
Active & Vigorous
Wake Up Fresh/Rested
Daily Life Interesting
Additional Comments
Submit
Should be Empty: