Healthcare
Mental Health Check-in form template
A gentle multi-step screening on a calming card: three opinion-scale questions (mood, anxiety, sleep), whether they'd like support, an open field, and an optional email. For clinics, EAPs and wellness teams.
Opinion scaleHealthcareConfidential
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Fully interactive — try filling it outWhat’s in the box
Gentle scales
Mood, anxiety, sleep.
Offer support
Connect if they want.
Safe space
Open, optional sharing.
Perfect for
- Clinics
- EAPs
- Wellness teams
- Counselors
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