Free Mental Wellbeing Assessment Form

Assess and support mental health with Template.net’s Mental Wellbeing Assessment Form Template. This fully customizable and editable form allows professionals to evaluate mental wellness effectively. With the intuitive Ai Editor Tool, you can easily personalize the template to meet the unique needs of individuals, ensuring a thorough and tailored mental health assessment every time.

	Not at All	Several Days	More than half the days	NearlyEveryday
Feeling nervous, anxious, or on edge
Not being able to stop or control
Worrying too much about different things
Trouble relaxing
Being so restless that it is hard to sit still
Becoming easily annoyed or irritable
Feeling afraid as if something awful might happen

	Not at All	Several Days	More than half the days	Nearly Every day
Little interest or pleasure in doing things
Feeling down, depressed, or hopeless
Trouble falling or staying asleep, or sleeping too much
Feeling tired or having little energy
Poor appetite or overeating
Feeling bad about yourself- or that you are a failure or have let yourself or your family down
Trouble concentrating on things, such as reading the newspaper or watching television
Moving or speaking so slowly that other people could have noticed? Or the opposite- being so fidgety or restless that you have been moving around a lot more than usual
Thoughts that you would have be better off dead

Free Mental Wellbeing Assessment Form

Full Name

Over the last 2 weeks, how often have you been bothered by the following problems?

Over the last 2 weeks, how often have you been bothered by the following problems?

Additional information if you need:

Thank you for submission!

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