Healthcare & wellbeing
Wellbeing check-in
For teams running a regular wellbeing check. It deliberately does not score or categorise anyone: it asks how someone is and offers a way to ask for support.
- Questions
- 5
- Takes about
- 2 min
- Style
- One at a time
- Scoring
- None
Free, no card. It lands in your workspace as an editable draft.
Worth knowing
- Don't turn this into a score. A number attached to someone's mental health invites exactly the wrong kind of management.
What's in it
How are you doing?
Welcome screen
- 1
How are your energy levels at the moment?
Opinion scale
- 2
How manageable is your workload?
Opinion scale
- 3
How supported do you feel?
Opinion scale
- 4
Anything you'd like to say?
Long text
- 5
Would you like someone to get in touch?
Yes / No
Thank you
Ending
How to use this template
Open it as a draft
Press "Use this template" and it lands in your workspace as an editable form with all 5 questions already in it. No card, and nothing is published until you say so.
Cut what you do not need
Every question you remove is one fewer reason to abandon the form. It takes about 2 minutes to fill in as it stands, and that is the number worth protecting.
Add from the question bank
Pick what you are missing from the questions below. Drag any of them in, change the wording, and use conditional logic so people only see the ones that apply to them.
Share it, or put it on your own site
Publish to get a link, or embed it in a page you already have. Answers arrive in your dashboard, and you can send them on to anywhere else with a webhook or an integration.
32 wellbeing check-in form questions to choose from
A wellbeing check-in is only ethical if somebody reads it and acts. Collecting signals of distress and filing them is worse than not asking.
Put the support information on the form itself, not only in the follow-up. Some people will take it and never submit, and that is a good outcome.
How they are
- How have you been feeling over the past two weeks?
- How is your mood today? (1 to 5)
- How well have you been sleeping?
- How is your energy?
- How is your appetite?
- How well are you able to concentrate?
- Have you been able to enjoy things you usually enjoy?
- How would you describe your stress level?
Work and life
- Is your workload manageable at the moment?
- Are you able to switch off outside working hours?
- Is anything at work weighing on you?
- Is anything outside work affecting you?
- Do you feel supported by your team?
- Do you feel able to ask for help?
- Has anything changed recently?
- Is there anything you are dreading?
Support
- What would help most right now?
- Is there anything we could change?
- Would you like to speak to someone?
- Would you prefer that to be a manager, HR, or someone independent?
- Do you know what support is available to you?
- Would information about it be useful?
- Are you already getting support?
- Is there anything you would like kept confidential?
Following up
- Would you like someone to contact you?
- How would you prefer to be contacted?
- When would be a good time?
- Would you rather this stayed anonymous?
- Is this urgent?
- Do you need help today?
- Is there anything else you want to tell us?
- Would you like to do this check-in again in a month?
Wellbeing Check-In form questions, answered
- What should a wellbeing check-in ask?
- A few consistent questions about mood, sleep and workload, and one open question about what would help. Keep the wording identical each time so the change over weeks is readable.
- Should a wellbeing survey be anonymous?
- Offer the choice. Anonymous gets more honest answers; identified lets you actually help the person who needs it. Make contact details optional and say clearly what happens either way.
- What should happen if someone reports they are struggling?
- Someone should contact them, quickly, and the form should say who and how soon. Put crisis and support numbers on the form itself, because some people will take those and never press submit.
- How often should wellbeing check-ins run?
- Monthly or quarterly. Weekly becomes a box-ticking exercise that people answer identically, and the responses stop meaning anything.
- Is this wellbeing check-in form template free?
- Yes. Use it, publish it and collect answers on the free plan with no card. Paid plans add things like payments, scheduling, removing our badge and your own domain, but none of them are needed to run this form.
- Do I need an account to use it?
- You need one to edit and publish, because the form has to live somewhere and the answers have to come back to you. Signing up takes about a minute and does not ask for a card. The people filling your form in never need an account.
- Can I change the questions?
- All of them. The template is a starting point, not a fixed form: add, remove, reword and reorder anything, change the look, and use logic so people only see the questions that apply to them.
- Can I put it on my own website?
- Yes. Embed it in a page you already have, or share the link. On a paid plan you can serve it from your own domain so the address says your name rather than ours.
- Where do the answers go?
- Into your dashboard, where you can read, search and export them as CSV. You can also have each response emailed to you, pushed to another tool with a webhook, or sent to a connected integration.
- How long does this form take to fill in?
- About 2 minutes as it stands, across 5 questions. Every question you cut brings that down, and shorter forms get finished more often.
Worth reading next
- What the rules actually ask of a small business formMost compliance advice is written for companies with legal departments. Here is the short version for a form that collects names and email addresses.
- The five accessibility fixes that matter most on a formNot a WCAG checklist. The handful of things that decide whether somebody using a screen reader or a keyboard can actually finish.