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* 1. What is your age?

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* 2. What is your gender?

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* 3. What is your ethnicity? (Please select all that apply.)

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* 4. What is the name of the town or village that you live in?

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* 5. Wellbeing is defined as a state of being comfortable, healthy and happy.

Indicate below how you feel about your wellbeing currently by highlighting the relevant number of smiley faces below (1 being low & 5 being high).

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* 6. How happy do you feel about the following in your life?

  Not happy Could be better OK Very Happy Doesn't apply to me
School/College
Work
Family
Home Life
Friends
Exams
Money
The Future
Personal Safety
Outside Activities
Social Media

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* 7. If you're not happy about any of the above, can you tell us why?

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* 8. What do you do to improve your mood? (tick all that apply)

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* 9. When you need to talk to someone, who do you speak to?

  Never Sometimes Always
Family
Friend
Teacher
Youth Worker
Counsellor
Helpline

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* 10. What other things might improve your mood?

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* 11. What activities would you do from the choice below to help improve your mood (these are just examples)?

  Would not do Would consider Would definitely do
Sports Activities: Football, Tournaments, Basketball
Music Workshops Drumming, Open Mic, DJ-ing, Singing
Other Physical Activities: Climbing Wall, Nerf Battles, Inflatable Obstacles, Trampolining
Wellbeing Workshops: Meditation, Yoga, Pilates, Mindfulness
Creative Arts: Painting, Crafting, Photography, Beauty, Fashion
Counselling Therapies: 1-2-1 Sessions, Group Sessions, Pet Therapy
Other Activities: Cookery, Writing, Other skills

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* 12. Support with your wellbeing can come from your friends & family, your local community such as school and neighbours & your local services such as youth clubs, local GP's etc.

Indicate how supported you feel with your wellbeing by highlighting the hearts below (1 heart being unsupported and 5 hearts being very supported)?

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* 13. Is there anything else that could help improve your mood and wellbeing?

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* 14. Do you have any other comments, questions, or concerns?

0 of 14 answered
 

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