Online Mental Health Questionnaire

Mental health refers to an individual’s emotional well being and it is essential to lead a healthy life and fully enjoy all that life has to offer. Online Mental health questionnaire tests you on a concrete set of parameters and analysis of the answers helps make conclusions about the individual’s mental state.

Sample online Mental Health Questionnaire

Name: ______________________

Sex: _________________________

Marital Status: __________________

Age: ___________________

Occupation: _____________________

Hobbies: ____________________

Kindly answer the following Questions:

1. Do you suffer from hair problems like hair loss etc.?

a. Yes

b. No

2. Do you have frequent headaches? How frequent and how long do they generally last?

__________________________________________

3. Is it hard to manage close relationships like friends, family or other loved ones? (e.g. do you get into unnecessary fights over small issues)

____________________________________________

4. Do you have irregular sleep timing or sleep for short hours or have a light sleep?

_____________________________________________________

5. Is it difficult for you to focus on a single problem at hand?(Personal or professional)

_____________________________________

6. How often do you go out with friends or attend social get-togethers/ dos?

_____________________________________________________

7. Do you enjoy going out for such events or functions or are you just fulfilling a social obligation or doing so to keep your others off your back?

_________________________________________________

8. Do you experience an unexplained urge to lie when asked a question?

a. Never

b. Yes, at times its funny

c. Yes, almost always.

9. Are you tempted to steal something when you it puts in a difficult place and create problems for you or somebody close to you on getting caught?

_____________________________________________________

10. Does it happen that you completely forget about a task you were suppose to do even after you were reminded repeatedly?

________________________________________________