Name *

First Name

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On a scale of 1 to 5, how satisfied are you with your overall current emotional state?

1 being very unsatisfied, 5 being very satisfied

1

2

3

4

5

On a scale of 1 to 10, how well do you manage stress and pressure in your daily life?

1 being handling stress & pressure poorly, 10 being handling stress & pressure very well.

A. 1-4

B. 5-7

C. 8-10

In difficult situations, how often do you find it easy to maintain a positive outlook?

1 being very poorly, 5 being very well

1

2

3

4

5

How would you rate your ability to adapt to change and navigate uncertainty?

1 being very poorly, 5 being very well

1

2

3

4

5

Do you often find yourself able to stay focused and composed during emotionally challenging moments?

1 being never, 5 being very often

1

2

3

4

5

How frequently do you engage in activities or practices that promote your mental and emotional well-being?

1 being never, 5 being very frequently

1

2

3

4

5

On a scale of 1 to 10, how satisfied are you with your current coping mechanisms for handling life's ups and downs?

1 being not very satisfied, 10 being very satisfied

A. 1-4

B. 5-7

C. 8-10

Reflecting on the past year, how would you rate your overall emotional well- being and resilience?

1 being very poor, 5 being very good

1

2

3

4

5