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Test Your Mental Health

1. Age:

2. Gender:
Male
Female
Others
Prefer not to say

3. Overall how would you rate your physical health?

4. Overall how would you rate your mental health?

5. Have you seen a therapist in the recent past?
Yes
No

6. Are you currently taking any medication?
Yes
No

7. How many hours do you sleep per day?

8. How is your quality of sleep?

9. What is your relationship status?

10. Are you satisfied with your current relationships and family ?
Yes
Sometimes
No

11. How often do you smoke?

12. How often do you drink?

13. Have you changed your job recently?
Yes
No
NA

14. Have you changed your routine recently?
Yes, quite a bit
Yes, slightly
Not at all

15. Are you going through a tough emotional situation?
Yes
No

QuMindWell is the smart way to care for your mind.

Katasur, Mohammadpur, 1207 Dhaka, Bangladesh
+8801793651750
pulokbiswas.cse@gmail.com

QuMindWell

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