Mental Health Check-In

Please answer honestly. Your responses are strictly confidential.

1. Have you been feeling bad lately?

2. Are you struggling with depression?

3. Are you experiencing family conflict?

4. Are you withdrawing from social situations?

5. How often do you feel anxious?

6. How is your sleep quality?

7. What is your overall energy level?

8. How would you rate your work/study stress?

Anything else you'd like to add?

Optional: Briefly explain what is on your mind.

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