The Emotional Wellness Assessment Form Template is an essential resource for health organizations, therapists, and wellness groups.
It is designed to help individuals assess their emotional well-being and serves as a first step towards recognizing their mental health needs.
How Does the Emotional Wellness Assessment Form Template Work?
This template utilizes the WPForms Pro License along with the Survey and Polls Addon, enabling effective mental health evaluations.
This setup also allows for the responses to be visually represented through charts and graphs, making it easier to understand the outcomes. Fields include:
- Personal Information:
- Name: Starts the form on a personal note by asking for the individual’s name.
- Age: Age provides context to understand the responses better.
- Email: Captures email for sending further resources or support if needed.
- Phone: An essential contact option for urgent communication needs.
- General Health:
- Do you have any chronic illnesses? Insight into physical health issues that might be affecting emotional well-being.
- Are you currently on any medication? It’s important to know about medications as they can influence mood and emotions.
- Wellness Questions:
- Set of Questions: A sequence of questions crafted to measure emotional wellness and detect issues.
- Stress Level Rating: A simple scale from 1 to 10 to gauge current stress levels, offering a quick snapshot of emotional state.
- Support System Query: Checks the strength of the individual’s personal support network, which is vital for resilience and emotional health.
- Consent for Follow-Up: Ensures participants agree to be contacted for additional support or information, maintaining respect for their privacy.
The Emotional Wellness Assessment Form Template from WPForms is a valuable tool for anyone looking to offer support and understand more about their emotional health. It bridges the gap between individuals and professional help.
