Help! Corporate Mental Wellness Pilot Study
Hello!  My name is Kristin Petrucci.  I am a Transformational Speaker and Corporate Mental Wellness Expert.  I am conducting a pilot study to help evaluate what working professionals want for their mental wellness care at work as well as how they are affected by stress in and outside the workplace.

Survey is for 18 and older employed 30+ hours.

Time commitment:  approximately 4 minutes.
Thank you in advance!
Contact me: kptransforms@gmail.com 
Sign in to Google to save your progress. Learn more
Gender *
Age *
Personal Annual Gross Income *
Role at work--no specification needed *
State/Province/Country of Residence *
In the past two weeks I have mainly felt, *
Depressed
Unsatisfied
Indifferent
High and Low
Happy
At Work
At Home
With friends
With Family
Please answer the following:  In the past two weeks at work, *
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
I haven't felt like I had enough time to get things done
I felt very sensitive and irritable
I felt stressed out overall
I have felt accomplished
In the past two weeks how do you think stress has affected your productivity at work? *
Not at all
Greatly affects my productivity
In the past two weeks I have: *
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
Does not apply
Had little or no pleasure in doing things
Felt down, depressed or hopeless
Had trouble falling, or staying asleep
Felt tired or unmotivated
Had a poor appetite or over-ate
Felt bad about myself
Wanted to hurt myself
Contemplated suicide
Relying on the answers above, how has your productivity been affected? *
Not at All
Greatly impaired my productivity
If "Other" please elaborate:
How many mental health sick days have you taken in the past  2 months? (you felt tired or stressed out and needed a break) *
If you could have weekly allotted time at work to take care of your mental health, how many hours would benefit you most? *
hour
hours
In which ways would you prefer to take care of your mental health at work? (mark all that apply) *
Required
If "Other" what would that be?
Which of the following is your preferred way to receive appreciation at work? *
If other please elaborate:
How does your work culture affect your mental health? *
What do you do to manage stress? *
If feeling down what do you do to feel better?
What do you wish your employer would offer you to help with mental health care? *
If you would like to be entered in the $50 Amazon gift card drawing and receive the results of this pilot study, enter your email address below.  Your answers will remain anonymous.  
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms