Free Plan

Step 2: Mental Health and Emotional Well-being

On a scale of 1 to 10, how would you rate your overall mood in the past two weeks? Have you experienced any of the following in the past month? (Check all that apply) How often do you feel overwhelmed or unable to cope with daily responsibilities? Never Rarely Sometimes Often Always Have you experienced any significant life changes or stressful events recently? Do you have a history of mental health conditions? No Yes

Step 3: Anxiety and Stress

How often do you feel anxious or worried? Never Occasionally Frequently Almost always Do you experience physical symptoms when you feel anxious? No Yes How well do you manage stress on a daily basis? Very well Well Fair Poorly Very poorly

Step 4: Relationships and Support

Do you have someone you can talk to about your feelings and concerns? Yes No How satisfied are you with your current social relationships? Very satisfied Satisfied Neutral Dissatisfied Very dissatisfied Have you experienced conflicts or difficulties in your relationships recently? No Yes

Step 5: Coping Mechanisms and Habits

What activities or hobbies do you engage in to relax or unwind? Do you use any substances to cope with stress or emotions? No Yes How often do you exercise or engage in physical activity? Daily Several times a week Occasionally Rarely Never Do you practice any mindfulness or relaxation techniques? No Yes

Step 6: Professional Help and Resources

Have you ever sought professional help for your mental health? No Yes Are you currently seeing a mental health professional? No Yes

Step 7: Open-ended Questions

What are your main concerns about your mental health currently? What changes or improvements would you like to see in your mental health? Is there anything else you would like to share about your mental health journey?

Step 8: Consent and Confidentiality

Do you consent to having this information reviewed by a qualified mental health professional for further assistance? No Yes Would you like to receive information about resources and support available for mental health? No Yes