Mood & Feelings Questionnaire

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This form is about how you might have been feeling or acting recently.

For each question, please check how you have been feeling or acting in the past two weeks.

If a sentence was not true about you, check NOT TRUE.
If a sentence was only sometimes true, check SOMETIMES.
If a sentence was true about you most of the time, check TRUE.

Score the MFQ as follows:
NOT TRUE = 0
SOMETIMES = 1
TRUE = 2

Full Name *

Phone Number *

INSTRUCTIONS: This scale is designed for your personal use. There are no right or wrong answers. Usually your first response is the best. Please print these pages out for your personal use. You may also bring this assessment with you to your appointment and discuss the findings during your visit.

I felt miserable or unhappy.

Not True

Sometimes

True

Clear selection

I didn’t enjoy anything at all.

Not True

Sometimes

True

Clear selection

I felt so tired I just sat around and did nothing.

Not True

Sometimes

True

Clear selection

I was very restless.

Not True

Sometimes

True

Clear selection

I felt I was no good anymore.

Not True

Sometimes

True

Clear selection

I cried a lot.

Not True

Sometimes

True

Clear selection

I found it hard to think properly or concentrate.

Not True

Sometimes

True

Clear selection

I hated myself.

Not True

Sometimes

True

Clear selection

I was a bad person.

Not True

Sometimes

True

Clear selection

I felt lonely.

Not True

Sometimes

True

Clear selection

I thought nobody really loved me.

Not True

Sometimes

True

Clear selection

I thought I could never be as good as other kids.

Not True

Sometimes

True

Clear selection

I did everything wrong.

Not True

Sometimes

True

Clear selection

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