Please click one circle for each of the 20 items:

1. Are you experiencing any problems in your life right now?
2. Are you experiencing any job or school-related problems?
3. Are you experiencing financial problems?
4. Are you happy with your social relationships?
5. Is sleep a problem for you?
6. Are you happy with your family relationships?
7. Do others put you down?
8. Are you depressed?
9. Are you happy with things the way they are?
10. How much do you like yourself?
11. Are you satisfied with the activities that you are able to do?
12. Do you feel "stressed out"?
13. Are you satisfied with your ability to talk with others?
14. Are you angry?
15. Are you fearful or anxious?
16. How often do you criticize yourself?
17. Are any medical problems affecting you adversely?
18. Do you worry about things?
19. Do you use drugs or alcohol more than you should?
20. Do you think negative thoughts?

Please complete to obtain your results.