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Depression Screening Program Online Assessment
This assessment takes 3 mins to complete
Male
Female
Have you had a child in the past year - as either parent, by birth, or through adoption?
Yes
No
Are you currently being treated, or sought help in the past, for low mood or depression?
I'Ve Never Sought Help For Low Mood Or Depression
I'M Currently Being Treated For Low Mood Or Depression
I'Ve Sought Help Or Been Treated In The Past
Are you currently being treated, or sought help in the past, for bipolar disorder?
I'Ve Never Been Treated For Bipolar Disorder
I'M Currently Being Treated For Bipolar Disorder
I'Ve Sought Help Or Been Treated In The Past
Are you currently being treated, or sought help in the past, for anxiety?
I'Ve Never Been Treated For Anxiety
I'M Currently Being Treated For Anxiety
I'Ve Sought Help Or Been Treated In The Past
Please indicate if you are currently being treated, or ever have been treated, for any of the following conditions.
Substance Use Problems
Cancer
Diabetes
Chronic Pain
Hiv
A Thyroid Condition
Psychosis
Another Condition
What is your marital status?
Married
Living With Partner
Widowed
Saparated Or Divorced
Never Married
What is your employment status?
Student
Full Time
Part Time
Unemployed Or Looking For Work
Unemployed Or Not Look For Work
Retired
Please indicate your primary ethnic or racial group:
Indigenous
Black
White
Chinese
Filipino
Korean
Japanese
Latin American
Middle Eastern
South Asian
South Ease Asian
Other
indicate how you have been feeling over the past week: I have been able to laugh and see the funny side of things:
As Much As I Always Could
Not Quite So Much Now
Chinese
Filipino
Korean
Japanese
Latin American
Middle Eastern
South Asian
South Ease Asian
Other
Things have been getting on top of me?
Yes, Most Of The Time I Haven't Been Able To Cope
Yes, I Haven't Been Coping As Well As Usual
No, Most Of The Time I'Ve Coped Quite Well
No, I'Ve Been Coping As Well As Ever
I've looked forward with enjoyment to things
As Much As I Ever Did
Rather Less Than I Used To
Definitely Less Than I Used To
Hardly At All
I've been so unhappy that I've had difficulty sleeping?
Yes, Most Of The Time
Yes, Sometimes
Not Very Often
No, Not At All
I blame myself unnecessarily when things went wrong?
Yes, Most Of The Time
Yes, Some Of The Time
Not Very Often
No, Never
I've felt sad or miserable?
Yes, Most Of The Time
Yes, Some Of The Time
Not Very Often
No, Never
I've been anxious or worried for no reason?
No, Not At All
Hardly Ever
Yes, Sometimes
Yes, Very Often
I have been so unhappy that I have been crying?
Yes, Most Of The Time
Yes, Quite Often
Only Occasionally
No, Never
I've felt scared or panicky for no very good reason
Yes, Quite A Lot
Yes, Sometimes
No, Not Much
No, Not At All
The thought of harming myself has occurred to me
Yes, Quite Often
Sometimes
Hardly Ever
Never
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