Mental Health Awareness Pre-test Assessment
Please complete this form to help us understand your current awareness and attitudes toward mental health. Your responses are confidential and will be used for educational purposes only.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Age
*
Gender
Male
Female
Non-binary
Prefer not to say
Other
Have you ever participated in a mental health awareness program before?
*
Yes
No
Please rate your current knowledge about mental health.
*
No knowledge
1
2
3
4
Very knowledgeable
5
1 is No knowledge, 5 is Very knowledgeable
How comfortable are you discussing mental health topics with others?
*
Not comfortable
1
2
3
4
Very comfortable
5
1 is Not comfortable, 5 is Very comfortable
Which of the following do you believe are symptoms of mental health challenges? (Select all that apply)
*
Changes in mood
Difficulty sleeping
Loss of interest in activities
Physical pain with no clear cause
Other
Please indicate your level of agreement with the following statements about mental health.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Mental health is as important as physical health.
1
2
3
4
5
People with mental health challenges can recover.
6
7
8
9
10
Talking about mental health helps reduce stigma.
11
12
13
14
15
Seeking help for mental health concerns is a sign of strength.
16
17
18
19
20
What do you hope to learn or achieve from this mental health awareness program?
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