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Well-being self-check

Survey ID

Real Assessment Name

GAID

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Please respond to each item by selecting how you have felt in the last two weeks:

*This question is required.0: At no time, 1: Some of the time, 2: Less than half the time, 3: More than half the time, 4: Most of the time, 5: All of the time

Space Cell	0	1	2	3	4	5
I have felt cheerful in good spirits.	I have felt cheerful in good spirits.: 0	I have felt cheerful in good spirits.: 1	I have felt cheerful in good spirits.: 2	I have felt cheerful in good spirits.: 3	I have felt cheerful in good spirits.: 4	I have felt cheerful in good spirits.: 5
I have felt calm and relaxed.	I have felt calm and relaxed.: 0	I have felt calm and relaxed.: 1	I have felt calm and relaxed.: 2	I have felt calm and relaxed.: 3	I have felt calm and relaxed.: 4	I have felt calm and relaxed.: 5
I have felt active and vigorous.	I have felt active and vigorous.: 0	I have felt active and vigorous.: 1	I have felt active and vigorous.: 2	I have felt active and vigorous.: 3	I have felt active and vigorous.: 4	I have felt active and vigorous.: 5
I woke up feeling fresh and rested.	I woke up feeling fresh and rested.: 0	I woke up feeling fresh and rested.: 1	I woke up feeling fresh and rested.: 2	I woke up feeling fresh and rested.: 3	I woke up feeling fresh and rested.: 4	I woke up feeling fresh and rested.: 5
My daily life has been filled with things that interest me.	My daily life has been filled with things that interest me.: 0	My daily life has been filled with things that interest me.: 1	My daily life has been filled with things that interest me.: 2	My daily life has been filled with things that interest me.: 3	My daily life has been filled with things that interest me.: 4	My daily life has been filled with things that interest me.: 5