Please answer honestly. There are no right or wrong answers.
Name: ___________________
Class/Grade: _____________
Date: ___________________
1. How often do you feel sad or down?
A) Never
B) Sometimes
C) Often
D) Always
2. How often do you feel worried or anxious?
A) Never
B) Sometimes
C) Often
D) Always
3. How often do you feel stressed about schoolwork or exams?
A) Never
B) Sometimes
C) Often
D) Always
4. How often do you overthink small problems?
A) Never
B) Sometimes
C) Often
D) Always
5. How often do you have trouble sleeping because of worries?
A) Never
B) Sometimes
C) Often
D) Always
6. How often do you feel lonely even when around friends?
A) Never
B) Sometimes
C) Often
D) Always
7. How often do you feel angry or irritable without reason?
A) Never
B) Sometimes
C) Often
D) Always
8. How often do you feel motivated and happy?
A) Never
B) Sometimes
C) Often
D) Always
9. How often do you talk to someone (friend, parent, teacher) when feeling sad or stressed?
A) Never
B) Sometimes
C) Often
D) Always
10. How often do you feel you can manage your emotions well?
A) Never
B) Sometimes
C) Often
D) Always