Mental Health Check-In Quiz
Answer a few questions to reflect on how you’re feeling today.
Name
*
First Name
Last Name
Email
*
example@example.com
Which statement best describes you today?
*
Very Good
Good
Neutral
Bad
Very Bad
How would you rate your current stress level?
*
No Stress
1
2
3
4
5
6
7
8
9
Extreme Stress
10
1 is No Stress, 10 is Extreme Stress
How well have you been sleeping lately?
Very Well
Well
Average
Poorly
Very Poorly
How connected do you feel to others right now?
Not at all connected
1
2
3
4
5
6
7
8
9
Very connected
10
1 is Not at all connected, 10 is Very connected
Is there anything else you’d like to share about your mental health today?
If you could change one thing right now, what would it be?
Submit Check-In
Should be Empty: