Self Assessment

Please answer the following questions. Results will be shown at the end
Have you been sleeping too little or too long lately?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Do you feel sad even when everything is generally fine?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Have you been experiencing fatigue without changes in physical activity and eating habits?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Do you feel restless and breathless often?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Do you feel your relationship with loved ones is deteriorating?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Do you seek validation from your family and friends for your work or decisions?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Do you feel like crying without any reason?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Have you stopped meeting or calling your friends?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Have you been getting angry or annoyed over little matters?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Are you struggling with deadlines at work?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Do you feel scared about what may happen in the future?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Do you feel scared and your heart trembles when you are with a group of strangers?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Do you find yourself stuck with thoughts which doesn’t seem to go away, even keeps you awake at night?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Do you find yourself not taking timely action for matters which needs attention?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Do you tend to do certain tasks repetitively, such as washing hands, checking locks, etc.?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Do you get upset easily when your loved ones or colleagues don’t agree with you?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Do you think other people are not careful regarding the future or upcoming challenges?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Have you been to a doctor for physical pains, stomach problems, headaches and been told that you have no medical problems?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much
Any of your behavior or feeling as per questions above which is continuing or getting worse in the past 3 weeks?*
- Not at all
- Just a little
- Somewhat
- Moderately
- Quite a lot
- Very much

Thank you for answering the questions. Please enter your name and phone number to see your assessment results. Your information will remain confidential with us
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