Healthcare
Mental Health Screening form template
Your wellbeing matters. This brief, private screening helps our clinicians understand your mood, stress, and sleep over the past two weeks. Your responses are confidential and reviewed with care.
ConfidentialClinician-Reviewed
What’s in the box
Private & Secure
Verified access keeps your responses confidential and protected end to end.
Whole Picture
A simple grid captures mood, sleep, and stress to give context, not labels.
Caring Follow-Up
A clinician reviews your check-in and reaches out with supportive next steps.
Perfect for
- Routine mental health check-ins
- Pre-appointment screening
- Employee wellbeing programs
- Therapy intake assessments
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