About this template
Prioritizing psychological well-being starts with proactive assessment and open communication. Whether you are a clinician evaluating patients, a school counselor checking in on students, or an HR leader monitoring team wellness, this Mental Health Survey template provides a structured way to gauge emotional and mental health.
Designed for clarity and sensitivity, this template helps you capture vital feedback on stress levels, coping mechanisms, and overall life satisfaction. Respondents can complete the assessment comfortably from any device, encouraging higher completion rates and more honest insights.
With Doc2Form, you can instantly turn this template into a fully functioning Google Form, allowing you to centralize responses in Google Sheets, analyze wellness trends over time, and take meaningful action to support your community.
Key features
- Assess stress levels and emotional well-being quickly
- Mobile-friendly layout for comfortable completions
- Standardized rating scales for easy trend analysis
- Fully customizable questions to suit your organization's needs
- Instant integration with Google Sheets for secure tracking
Use cases
- Routine clinical intake and psychological screenings
- Quarterly employee wellness and burnout check-ins
- University or school student support assessments
- Remote telehealth pre-visit questionnaires
What this form collects
- Full Name (Optional) (Short answer)Leave blank if you prefer to submit your responses anonymously.
- Role or Affiliation (Dropdown)Select the category that best describes your relationship with our organization.
- Overall, how would you rate your mental well-being over the past two weeks? (Linear scale)1 = Very Poor, 5 = Excellent
- How often have you felt overwhelmed, stressed, or anxious recently? (Multiple choice)Choose the option that best reflects your recent daily experience.
- How would you rate your current sleep quality? (Linear scale)Consider how rested you feel upon waking up.
- Which factors are contributing most to your stress right now? (Checkboxes)Select all that apply.
- Do you feel you have adequate support to manage your daily stress? (Multiple choice)Think about friends, family, colleagues, or professional resources.
- Would you like to speak with a counselor or wellness professional? (Multiple choice)If yes, our team can follow up with you confidentially.
- Contact Email (Short answer)Provide your email address only if you requested follow-up support above.
- Is there anything else you would like to share about your well-being or suggestions for improvement? (Paragraph)Share any additional thoughts, comments, or feedback.
FAQ
How can I customize this mental health survey template?
Once you open the template in Doc2Form, it generates a direct copy in your Google Drive. You can easily add, remove, or edit questions using the standard Google Forms editor.
Is this survey suitable for remote participants?
Yes. Respondents can complete the assessment from any smartphone, tablet, or desktop computer, making it ideal for telehealth or remote work environments.
Where are survey responses stored?
All submissions are saved securely in your Google account, and you can instantly link the form to Google Sheets to organize and review data.
Can I keep the responses anonymous?
Google Forms allows you to collect responses anonymously by disabling email collection settings in your form preferences.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.