Sentiment Reflection Worksheet Form
Use this worksheet to reflect on your current feelings and experiences. Your responses will help you gain insight into your emotional state and patterns.
Date of Reflection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Overall Sentiment Today
*
Very Negative
1
2
3
4
5
6
Very Positive
7
1 is Very Negative, 7 is Very Positive
Which word best describes your primary feeling right now?
*
Happy
Calm
Anxious
Frustrated
Sad
Other
Please rate the intensity of the following feelings you experienced today.
*
Rows
Not at all
Mild
Moderate
Strong
Joy
1
2
3
4
Calm
5
6
7
8
Worry
9
10
11
12
Irritation
13
14
15
16
Sadness
17
18
19
20
What contributed most to your current sentiment?
How did you respond to these feelings?
What is one thing you could do to improve your mood or maintain positive feelings?
Submit
Should be Empty: