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Employee Mental Health Check-in Form Template

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Employee Name

As a business owner, you’re dedicated to promoting employee well-being and fostering a supportive workplace culture. That’s where our Employee Mental Health Check-in Form Template comes into play.

Why Should I Use the Employee Mental Health Check-in Form Template?

This form is designed to facilitate open communication and provide a platform for employees to express their mental health status and needs. Here’s how it works:

  • Employee Information: We understand the importance of confidentiality and respect for employee privacy. Our form begins by collecting essential details such as the employee’s name and email address, ensuring that responses are securely recorded and communicated.
  • Check-in Details: To capture a snapshot of the employee’s mental health status, our form template includes fields for the date of the check-in and their current mental health status. Employees can choose from a dropdown menu of options ranging from feeling well to experiencing stress, overwhelm, frustration, or other emotions, allowing them to articulate their feelings accurately.
  • Factors Affecting Mental Health: Recognizing that various factors can impact mental well-being, our template provides employees with a dropdown menu to specify the factors contributing to their current mental health status. From workload and interpersonal dynamics to personal issues, health concerns, and relationships, employees can identify the underlying causes of their feelings.
  • Support Needed: Empathy and support are crucial components of a healthy workplace culture. Our form invites employees to specify the type of support they need, whether it’s additional resources, accommodations, or simply a listening ear.
  • Action Plan and Signature: In cases where action is needed to address the employee’s mental health concerns, our form includes a section for outlining an action plan. Additionally, the employee can sign the form, indicating their acknowledgment and consent for further support and follow-up.

With an Employee Mental Health Check-in Form, you can empower your employees to prioritize self-care, access support when needed, and thrive both personally and professionally. Get the template from WPForms today!