fbpx
01543 624117
Rugeley Leisure Centre, Burnthill Lane, WS15 2HZ
Search
Search
Register Your Interest!

Monitoring Form for Children [9-13]

Please answer the following questions as best you can. If you don’t understand a question or find it too difficult, feel free to leave it unanswered.
NeverAt least onceOn a few daysMost daysEvery day
I felt happy or satisfied
Never
At least once
On a few days
Most days
Every day
I felt down or sad
Never
At least once
On a few days
Most days
Every day
I felt engaged or focused on what I was doing
Never
At least once
On a few days
Most days
Every day
I felt energised or lively
Never
At least once
On a few days
Most days
Every day
I felt lonely
Never
At least once
On a few days
Most days
Every day
I felt everything I did was an effort
Never
At least once
On a few days
Most days
Every day
My sleep was restless
Never
At least once
On a few days
Most days
Every day
None of the timeRarelySome of the timeOftenAll of the time
I’ve been feeling excited about the future
None of the time
Rarely
Some of the time
Often
All of the time
I’ve been feeling good about myself
None of the time
Rarely
Some of the time
Often
All of the time
I’ve been feeling relaxed
None of the time
Rarely
Some of the time
Often
All of the time
I’ve been dealing with problems well
None of the time
Rarely
Some of the time
Often
All of the time
I’ve been having good times with family
None of the time
Rarely
Some of the time
Often
All of the time
I’ve been having good times with friends
None of the time
Rarely
Some of the time
Often
All of the time
I’ve been able to make up my own mind about things
None of the time
Rarely
Some of the time
Often
All of the time
Close
Search

Hit enter to search or ESC to close

cookie By using this website, you agree to our cookie policy. Close