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First Name *

Phone *

Are you or have you been having thoughts of suicide or homicide in the past 2 weeks?

Never

Rarely

Sometimes

Most Days

Any time you are having these thoughts, please call or text 988 (national suicide hotline). This is not a replacement for a Mental Health Expert and you should contact a Mental Health Expert.

Do you currently have a mental health provider?

Yes

Visit https://www.psychologytoday.com/us to find someone near you that can help alongside this app building tools.

Do you want reminders and other tools to help you find a mental health provider?

Yes

Which of these choices best describes your struggles?

Depression/Burnout

Anxiety/Stress

Both Depression & Anxiety

Need Resilience

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Little interest or pleasure in doing things

Not at all

Several days

More than half the days

Nearly every day

Feeling down, depressed, or hopeless

Not at all

Several days

More than half the days

Nearly every day

Trouble falling or staying asleep, or sleeping too much

Not at all

Several days

More than half the days

Nearly every day

Feeling tired or having little energy

Not at all

Several days

More than half the days

Nearly every day

Poor appetite or overeating

Not at all

Several days

More than half the days

Nearly every day

Feeling bad about yourself or that you are a failure or have let yourself or your family down

Not at all

Several days

More than half the days

Nearly every day

Trouble concentrating on things, such as reading the newspaper or watching television

Not at all

Several days

More than half the days

Nearly every day

Moving or speaking so slowly that other people could have noticed. Or the opposite being so fidgety or restless that you have been moving around a lot more than usual

Not at all

Several days

More than half the days

Nearly every day

Thoughts that you would be better off dead, or of hurting yourself

Not at all

Several days

More than half the days

Nearly every day

Over the last two weeks, how often have you been bothered by the following problems?

Feeling nervous, anxious, or on edge

Not at all

Several days

More than half the days

Nearly every day

Not being able to stop or control worrying

Not at all

Several days

More than half the days

Nearly every day

Worrying too much about different things

Not at all

Several days

More than half the days

Nearly every day

Trouble relaxing

Not at all

Several days

More than half the day

Nearly every day

Being so restless that it is hard to sit still

Not at all

Several days

More than half the days

Nearly every day

Becoming easily annoyed or irritable

Not at all

Several days

More than half the days

Nearly every day

Feeling afraid, as if something awful might happen

Not at all

Several days

More than half the days

Nearly every day

What helps you calm down when you are distressed for any reason? (Click all that apply)

Hot showers/Bath

Going for a walk/Exercise

Space from others

Pets

Hiking or going out in nature

Going for a drive

Talking with close friends or relatives

Listening to Music

What songs calm you down?

What songs encourage you or hype you up?

What songs help you to focus?

Congrats! You've completed the first step in building the tools to make you happier, good job!

Couch Coach Stories

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Smiles Davis

★ ★ ★ ★ ★

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Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua.

Smiles Davis

★ ★ ★ ★ ★

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Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua.

Smiles Davis

★ ★ ★ ★ ★

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