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Employee Mental Health and Well-Being Checklist
The purpose of this checklist is to help employees self-assess their mental health and well-being. It aims to identify areas where they may need support and provide guidance on seeking help. The checklist is confidential and designed to promote a healthy work-life balance and overall well-being.
1. Over the past two weeks, how often have you felt down, depressed, or hopeless?
(Required)
Not at all
Several days
More than half the days
Nearly every day
2. How often have you felt stressed due to work-related issues in the past month?
(Required)
Never
Rarely
Sometimes
Often
Always
3. How often have you felt anxious or worried in the past month?
(Required)
Not at all
Rarely
Sometimes
Often
Always
4. How often have you experienced trouble sleeping in the past month?
(Required)
Never
Rarely
Sometimes
Often
Always
5. Have you experienced any physical symptoms such as headaches, muscle tension, or fatigue recently?
(Required)
Never
Rarely
Sometimes
Often
Always
6. How satisfied are you with your current work-life balance?
(Required)
Very dissatisfied
Dissatisfied
Neutral
Satisfied
Very satisfied
7. Do you feel you have access to adequate support for mental health issues?
(Required)
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
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Total Score
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