Mental Fitness Self-Assessment Questionnaire
Reflect on your mental wellbeing and habits to gain insights into your overall mental fitness. Your responses are confidential and intended for self-reflection purposes only.
Full Name
First Name
Last Name
Age
How often do you feel able to cope with everyday stress?
*
Always
Often
Sometimes
Rarely
Never
Please rate your overall emotional wellbeing.
*
1
2
3
4
5
Over the past two weeks, how often have you experienced the following?
*
Rows
Never
Rarely
Sometimes
Often
Always
Felt optimistic about the future
1
2
3
4
5
Felt in control of your emotions
6
7
8
9
10
Felt overwhelmed by responsibilities
11
12
13
14
15
Had trouble sleeping due to stress
16
17
18
19
20
Felt connected to others
21
22
23
24
25
Which of the following best describes your ability to bounce back after setbacks?
*
Very resilient
Somewhat resilient
Neutral
Struggle to recover
Find it very difficult
How satisfied are you with your social connections and support network?
*
Not satisfied
1
2
3
4
5
6
7
8
9
Very satisfied
10
1 is Not satisfied, 10 is Very satisfied
How many hours of restful sleep do you typically get per night?
*
Less than 4 hours
4-6 hours
6-8 hours
More than 8 hours
What activities do you regularly engage in to support your mental fitness? (Select all that apply)
Physical exercise
Meditation or mindfulness
Socializing
Creative hobbies
Journaling
Other
Describe in your own words any current challenges or strengths related to your mental fitness.
Would you like to receive resources or support related to mental fitness?
Yes, please send me resources
No, thank you
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