Mental Health Screening Questionnaire
Educational screening support — not a diagnosis
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Mode: Adult Results: Screening % Unlocked sections: 0

Mental Health Screening Questionnaire

This tool looks for patterns in how you’ve been feeling and functioning. It produces screening matches to guide a conversation with a clinician.
This is not a diagnosis and not medical advice.

Safety: If you are in immediate danger or thinking about harming yourself or someone else, seek emergency help now (local emergency number, crisis line, or ER).
How to answer
  • Answer based on the past few weeks unless the question says otherwise.
  • If symptoms are mainly from alcohol/drugs/meds or a medical issue, mark that in the rule-out section.
  • Some sections only show if your answers suggest they’re relevant.
Mode
Who is this screening for?
“Child/Adolescent” mode changes some content and adds a few age-specific items.

Basic Info (optional)

Used only to label your results.
Optional
Name
Age
Sex
Gender identity

1) Start Here (Core Gates)

These decide which sections unlock next. Answer them first.
Tip If a section doesn’t appear, it didn’t unlock.

2) Rule-Outs (Medical, Sleep, Substance, Grief)

These reduce false positives (symptoms that have a better explanation).

3) Symptom Check (Shared Question Bank)

Questions are reused across multiple conditions so we don’t repeat the same thing 12 times.

Submit hides the form and shows results full-page. PDF export: Print → Save as PDF.