Over the past 2 weeks, how often have you felt...
1. Closer to your bigger life goals and aspirations
*
Select Answer
0 - Never
1 - Rarely
2 - Sometimes
3 - Half the time
4 - Very often
5 - Almost every day
2. A sense of balance in each day
*
Select Answer
0 - Never
1 - Rarely
2 - Sometimes
3 - Half the time
4 - Very often
5 - Almost every day
3. Focused on what matters most to you
*
Select Answer
0 - Never
1 - Rarely
2 - Sometimes
3 - Half the time
4 - Very often
5 - Almost every day
4. Fulfilled at the end of the day
*
Select Answer
0 - Never
1 - Rarely
2 - Sometimes
3 - Half the time
4 - Very often
5 - Almost every day
5. Confident in who you are / the person you’re becoming
*
Select Answer
0 - Never
1 - Rarely
2 - Sometimes
3 - Half the time
4 - Very often
5 - Almost every day
6. Energized by your daily activities
*
Select Answer
0 - Never
1 - Rarely
2 - Sometimes
3 - Half the time
4 - Very often
5 - Almost every day
7. Moments of genuine happiness throughout the day
*
Select Answer
0 - Never
1 - Rarely
2 - Sometimes
3 - Half the time
4 - Very often
5 - Almost every day
8. Grateful for what you have in life
*
Select Answer
0 - Never
1 - Rarely
2 - Sometimes
3 - Half the time
4 - Very often
5 - Almost every day
9. Closer to the person you aspire to be
*
Select Answer
0 - Never
1 - Rarely
2 - Sometimes
3 - Half the time
4 - Very often
5 - Almost every day
10. Productive toward your daily goals and tasks
*
Select Answer
0 - Never
1 - Rarely
2 - Sometimes
3 - Half the time
4 - Very often
5 - Almost every day
11. Confident in the direction that your life is going
*
Select Answer
0 - Never
1 - Rarely
2 - Sometimes
3 - Half the time
4 - Very often
5 - Almost every day
12. Excited by things to look forward to
*
Select Answer
0 - Never
1 - Rarely
2 - Sometimes
3 - Half the time
4 - Very often
5 - Almost every day
End of The Equilibrium Index By When Toys Age LLC
13. Little interest or pleasure in doing things?
*
Select Answer
0 - Not at all
1 - Several days
2 - More than half the days
3 - Nearly every day
14. Feeling down, depressed, or hopeless?
*
Select Answer
0 - Not at all
1 - Several days
2 - More than half the days
3 - Nearly every day
15. Trouble falling or staying asleep, or sleeping too much?
*
Select Answer
0 - Not at all
1 - Several days
2 - More than half the days
3 - Nearly every day
16. Feeling tired or having little energy?
*
Select Answer
0 - Not at all
1 - Several days
2 - More than half the days
3 - Nearly every day
17. Poor appetite or overeating?
*
Select Answer
0 - Not at all
1 - Several days
2 - More than half the days
3 - Nearly every day
18. Feeling bad about yourself - or that you are a failure or have let yourself or your family down?
*
Select Answer
0 - Not at all
1 - Several days
2 - More than half the days
3 - Nearly every day
19. Trouble concentrating on things, such as reading the newspaper or watching television?
*
Select Answer
0 - Not at all
1 - Several days
2 - More than half the days
3 - Nearly every day
20. Moving or speaking so slowly that other people could have noticed OR being so fidgety or restless that you have been moving around a lot more than usual?
*
Select Answer
0 - Not at all
1 - Several days
2 - More than half the days
3 - Nearly every day
21. Thoughts that you would be better off dead, or of hurting yourself in some way?
*
Select Answer
0 - Not at all
1 - Several days
2 - More than half the days
3 - Nearly every day
End of PHQ-9 By Pfizer Inc.
Age
Gender
*
Gender
Female
Male
Non-binary
Prefer not to answer
Marital Status
*
Marital Status
Single, never married
Married or domestic partnership
Divorced or separated
Widowed
Prefer not to answer
Employment
*
Employment
Employed for wages
Self-employed
Student
Homemaker
Military
Retired
Unable to work
Unemployed
Prefer not to answer
Ethnicity
*
Ethnicity
Asian / Pacific Islander
Black or African American
Hispanic or Latino
Native American / American Indian
White
Other
Prefer not to answer
Education
*
Education
No schooling completed
Nursery school to 8th grade
Some high school, no diploma
High school graduate, diploma or the equivalent
Some college credit, no degree
Trade/technical/vocational training
Associate degree
Bachelor’s degree
Master’s degree
Professional degree
Doctorate degree
Prefer not to answer
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