Wellbeing

Please answer the following questions based on the past two weeks: Feeling nervous, anxious or on edge Not at all (0 days)Rarely (1 to 3 days)Sometimes (4 to 7 days)Often (8 to 10 days)Nearly every day (11 to 14 days) Not being able to stop or control worrying Not at all (0 days)Rarely (1 to 3 days)Sometimes (4 to 7 days)Often (8 to 10 days)Nearly every day (11 to 14 days) Feeling down, depressed or hopeless? Not at all (0 days)Rarely (1 to 3 days)Sometimes (4 to 7 days)Often (8 to 10 days)Nearly every day (11 to 14 days) Had little interest or pleasure in doing things? Not at all (0 days)Rarely (1 to 3 days)Sometimes (4 to 7 days)Often (8 to 10 days)Nearly every day (11 to 14 days)

How would you rate your physical health? —Please choose an option—GoodAveragePoor

How would you rate your sleeping quality? —Please choose an option—GoodAveragePoor

How would you rate your appetite? —Please choose an option—GoodAveragePoor

Did you experience any significant life changes or stressful events? —Please choose an option—NoYes

Have you ever had any thoughts of harming yourself? NoYes

Have you ever attempted to harm yourself? NoYes

Have you ever harmed yourself to the extent where your life was at risk? NoYes

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Do you have any religious affiliations? NoYes

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