Covid-19 and Mental Health Survey Template Template

Looking for a paper-based survey data collection solution for your organization? Take a look at this covid-19 and mental health survey template template for your upcoming research project.

Our templates come with well-designed questions that can be machine-read to recognize the checkmarks using optical mark recognition (OMR) technologies. Open text areas recognized with handwriting recognition (HWR) technologies allowing you to write handwritten text and automatically convert to a digitized format.

Questions in this survey: 16, Language: English

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List of questions in this template

  1. I consent to take part in this survey?
  2. Select the race category that you feel you belong to:
  3. Select your sex:
  4. Select your age category:
  5. Are you employed at the moment?
  6. How many people currently live with you in your home?
  7. Have you previously been diagnosed with a mental health condition?
  8. If you have been diagnosed with a mental health condition, please select it from the list below:
  9. How many hours per day did you typically (on average) spend outside of your home/residence before the lockdown began?
  10. Do you think that the lockdown is a good idea?
  11. How stressed did you feel BEFORE the lockdown started?
  12. How stressed did you feel BEFORE the lockdown started? (Copy)
  13. Have you faced any specific challenges during the lockdown period? Please select as many as apply from the list below:
  14. During the lockdown, I have communicated with others by doing one or more of the following (select as many as apply to you):
  15. During the lockdown, I get my Covid-19 updates and information from the following sources (select as many as apply):
  16. During the lockdown, I feel better after I have: (select as many as apply)


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