Psychology questionnaire design is used to interview the individuals who are seeking some sort of psychologal assistance in order to deal with certain psychological condition. This questionnaire is used by the health institutions, hospitals and medical organization to collect the data on individual psychology health. However, the individual details and their recorded answers are kept secret. This psychological questionnaire can be attempted by visiting the online website of a particular health institution.

Sample Of Psychology Questionnaire Design:

Patient’s Personal Details:

Name: ______________

Sex: ________________

Marital Status: ______________

Address: __________________

Phone Number: _______________

E-mail id: _____________________

Q1. Are you experiencing any sort of psychological problem while you try to express yourself during a normal talk session?

  • Yes
  • No
  • Not sure
  • If yes, please describe it: __________________-

Q2. Do you have any sort of psychological history or have you been going through any kind of psychological problem in the past?

  • Yes
  • No
  • If yes, provide the details: ____________

Q3. Which of the following emotional activities are you noticing the most nowadays?

  • Lack of concentration
  • Frequent sadness
  • Mind racing and dizziness
  • Absence of bodily sensations
  • Other, please write: _____________________

Q4. Which of the following bodily activities are happening to your body frequently?

  • Face becoming hot
  • Mouth becoming dry
  • Trembling & shaking
  • Others, please specify: ___________

Q5. Tell us something about your relationship with your family.


Q6. How do you rate your psychological behaviour with your colleagues?

  • Excellent
  • Good
  • Normal
  • Average

Others, please mention: _______________

Q7.  Is there anything else you would like to tell us concerning your psychological condition?

  • Yes
  • No
  • If yes, write here: _______________



Psychological assessments