Mental Health Survey
1
.
Let’s begin. How frequently do you feel confident in yourself?
Often
Sometimes
Seldom
Never
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2
.
Alright! How would you rate your quality of sleep?
1
2
3
4
5
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3
.
So, have your eating habits changed recently?
Yes, I'm eating a lot lately.
No, it is the same.
Not much
Can't say
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4
.
Please tick the required boxes.
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5
.
We appreciate your honesty. Please indicate how frequently you counter the following situations.
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6
.
Almost done. Have you ever suffered/ are suffering from any mental health issues?
Yes
No
Can't say
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7
.
When was the last time you consulted a mental health therapist?
Less than six months ago
Six months ago
One year ago
Never
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8
.
Just have a few more questions. Please enter your date of birth.
Month
/
Day
/
Year
/
HH
/
MM
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9
.
...And which gender do you most identify with?
Male
Female
Other
Prefer not to say
Submit
Submit
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