How Our Mental Health Questionnaire Can Help You

Are you interested in learning more about your child’s mental health status? Take our brief questionnaire!

Please note: This questionnaire is a brief screening tool developed by mental health professionals at Sullivan + Associates Clinical Psychology. It is not intended for diagnostic purposes or to replace a formal mental health assessment. However, feel free to use it for personal interest and/or as a starting point towards improving your mental health and wellbeing. You may also want to share this information with the health professionals in your circle of care if you are concerned about your mental health.

Benefits of Taking our Mental Health Questionnaire

  • Easy to Do – It’s a rating scale style questionnaire. Just click on the selection that best describes you.
  • Confidential – Your responses and results are 100% confidential.
  • Direction – Suggests helpful next steps, such as suggestions for resources and services based on your responses.
  • Cost Effective – It’s free to use as many times as you want.
  • Quick to Use – It takes approximately 5-10 minutes to complete the test.
  • Immediate Results – You will receive your results immediately upon completing the test.
  • Free Report – If you enter your email address, you will receive a copy of your results. If you chose to provide your email address, your responses and results will remain 100% confidential.
  • Anonymous – You don’t need to provide any identifying information to complete the test.

Child Grief and Loss Questionnaire

Answer each question, then click submit to see your results.

Child Grief/Loss Mini-Questionnaire : Parents/Guardians
Have become socially isolated since the loss
Grief over the loss has impacted their school work
Avoid places, people, or situations that remind them of someone/something they have lost
Wish they could change their past with someone/something they have lost
Can't get rid of things that have little meaning because they remind them of someone/something they have lost
Try not to let themselves feel the emotions associated with grief
Struggle to do daily tasks because of grief
Have struggled to believe that the loss happened
Extremely sad compared to others about someone/something they have lost
Do a lot of things that make them feel like they haven't lost someone/something
Spend a lot of my time wishing that they did not lose someone/something
People tell them they need to move on/let go in relation to their grief
Avoid thinking about someone who died or something they have lost
Cry uncontrollably when they think about someone/something they have lost
Feel guilty that they weren't able to prevent the loss from happening

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