Employee Workplace Mental Health Screening
Employee Information
Full Name
Department
Email
Mental Health & Wellbeing
In the past two weeks, how often have you felt stressed at work?
Never
Rarely
Sometimes
Often
Always
How supported do you feel by your manager regarding your mental health?
Not at all supported
Somewhat supported
Very supported
Workplace Experience
Do you feel comfortable discussing mental health concerns at work?
Yes
No
Uncertain
What, if any, workplace changes would help support your mental wellbeing?
Additional Comments
Is there anything else you would like to share?