Well with the Word
Sign in to Google to save your progress. Learn more
Email *
Name (optional)
Are you a mom? *
Required
How mentally well do you feel? (how we think, feel, behave, cope with stressors, and relate to others)
Not well
Extremely well
Clear selection
How emotionally well do you feel? (connecting with, accepting, managing, and expressing emotions in healthy ways, your connection with yourself and your connections with others) *
Not well
Extremely well
What are your coping mechanisms? *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy