PRIMARY SURVEY

NAME: (NOT MANDATORY)

OCCUPATIONAL FIELD:
GENDER: Male / Female / other / Prefer not to say
AGE:

1. Have you had any problems with your work or daily life due to your physical health?
2. Have you had any problems with your work or daily life due to any emotional problems,
such as feeling depressed, sad or anxious?
3. How would you rate your mental well-being?
Excellent/Somewhat good/Average/Poor/Not sure
4. How often do you experience below?
Calm and Peaceful/Energetic/gloomy/Angry
Never/once in a while/about half the time/most of the time/always
5. Does your health (mental and physical) limit you in doing daily activities?
Light physical activity/moderate physical activity/heavy physical activity
Very less/moderately/very much/no problem
6. How many hours do you sleep per day on a normal working day?
Less than 4/ 4 to 6 / 7 to 9 / 9+
7. How is the quality of you sleep on a normal working day?
Very bad / bad / normal / good / very good
8. How often do you feel positive about your life?
Never/once in a while/about half the time/most of the time/always
9. Have you lived/worked/studied in a city? Which city/cities?
10. What are your aids in stress management?
11. Do you feel like you can talk to someone or ask for help with your mental or physical health
issues?
12. How would you describe your interpersonal relationships?
13. How would you describe your work-life balance? How can you improve it?
14. How many hours do you devote to your wellbeing in a day?
15. Would you be interested in having access to well-being resources in your vicinity? (Such as
meditation sessions, mindfulness classes, stress reduction workshops, etc.).Any suggestions.