Low Mood Indicator

Please complete the form below about your mood. This form is for completion by potential and current RESEARCH PARTICIPANTS

Choose the answer for each of the questions as you have been in the previous week. Each has a score 0 - 3

Your Total Score indicates:

0 - 7 = not significant

8 - 10 = possible or borderline low mood

11 - 21 = significant low mood

Date:*

Your name:*

Your email:*

Repeat Your email:*

I give my full consent to be contacted by email by Debbie Featherstone*

I agree

Please answer ALL seven questions. Your answers need to reflect how you have been during the previous week

1. I still enjoy the things I used to enjoy*

2. I can laugh and see the funny side of things*

3. I feel cheerful*

4. I feel as if I am slowed down*

5. I have lost interest in my appearance*

6. I look forward with enjoyment to things*

7. I can enjoy a good book, or radio or TV programme*

Thank you for completing your answers. Is there anything you would like to add?

Now press SEND - you will receive a copy of your answers by email