Pre-HASP Questionnaire

Before you begin the Help and Support Programme, we ask you to complete a short questionnaire using the Mental Health Quality of Life (MHQoL) tool.
The MHQoL is a recognised measure used to understand how someone is feeling in relation to their mental and emotional wellbeing.

It helps us understand how things are for you at the start of the programme so we can better support your journey and understand any changes over time. There are no right or wrong answers; this is simply about your own experience.ย 

Once submitted, you will receive an email explaining the next steps.

This field is for validation purposes and should be left unchanged.
Name(Required)
Gender(Required)
Email
1. Self Image(Required)
Please indicate below which statement best describes your situation today by ticking one box.
2. Independence(Required)
(For example: freedom of choice, financial, co-decision making). Please indicate below which statement best describes your situation today by ticking one box.
3. Mood(Required)
Please indicate below which statement best describes your situation today by ticking one box.
4. Relationships(Required)
(For example: partner, children, family, friends). Please indicate below which statement best describes your situation today by ticking one box.
5. Daily Activities(Required)
For example: work, study, household, leisure activities. Please indicate below which statement best describes your situation today by ticking one box.
6. Physical Health(Required)
Please indicate below which statement best describes your situation today by ticking one box.
7. Future(Required)
Please indicate below which statement best describes your situation today by ticking one box.
8. Psychological Well-Being(Required)
On the scale below, please indicate how you rate your psychological well-being. (0 represents the worst imaginable psychological well-being, while 10 represents the best imaginable psychological well-being).
What current challenges are you facing that you believe the Help & Support Programme could assist you with overcoming?

9. Availability

9. AvailabilityWhich days would suit you best for your weekly mentoring sessions?
9. Availability Which days would suit you best for your weekly mentoring sessions?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
11. Your Mentor(Required)
Do you have a preference for your mentor’s gender?
How can we help today?