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MadlySane MindCheck
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Step
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Name
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Section 1: Emotional Well-Being
Emotional Well-Being Questionnaire
Calculate your total score: Add up the points for all four questions to get your total Emotional Well-Being score.
Question 1: How often do you feel down or depressed?
*
Select
Rarely (1)
Occasionally (2)
Sometimes (3)
Often (4)
Always (5)
1: score_EW4 you
Question 2: How often do you feel anxious or stressed?
*
Select
Rarely (1)
Occasionally (2)
Sometimes (3)
4 (Often)
Always (5)
Question 3: How often do you feel overwhelmed by your responsiblities?
*
Select
Rarely (1)
Occasionally (2)
Sometimes (3)
Often (4)
Always (5)
Question 4: How often do you feel lonely or isolated?
*
Select
Rarely (1)
Occasionally (2)
Sometimes (3)
Often (4)
Always (5)
Section 2: Life Satisfaction
Life Satisfaction Questionnaire
Calculate your total score: Add up the points for all four questions to get your total Life Satisfaction score.
Question 1: How satisfied are you with your personal relationships?
*
Select
Very Dissatisfied (1)
Dissatisfied (2)
Neutral (3)
Satisfied (4)
Very Satisfied (5)
Question 2: How satisfied are you with your work or daily activities?
*
Select
Very Dissatisfied (1)
Dissatisfied (2)
Neutral (3)
Satisfied (4)
Very Satisfied (5)
Question 3: How satisfied are you with your physical health?
*
Select
Very Dissatisfied (1)
Dissatisfied (2)
Neutral (3)
Satisfied (4)
Very Satisfied (5)
Question 4: How satisfied are you with your overall quality of life?
*
Select
Very Dissatisfied (1)
Dissatisfied (2)
Neutral (3)
Satisfied (4)
Very Satisfied (5)
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