Registration: Optimizing Mental Health 1. Role(Required)Attending PhysicianFellowAPP (PA/NP)Other2. Gender(Required)MaleFemaleOtherPrefer not to answer3. I feel burned out by my work(Required)0 – never1 – a few times a year or less2 – once a month or less3 – a few times a month4 – once a week5 – a few times a week6 – every day4. I have become more callous towards people since I took this job(Required)0 – never1 – a few times a year or less2 – once a month or less3 – a few times a month4 – once a week5 – a few times a week6 – every day5. How would you rate your mental health?(Required)12345(1 being lowest and 5 highest)6a. I plan to prioritize my mental health and that of my colleagues by: Treating my mental health as a vital sign and periodically assessing(Required)0 – never1 – a few times a year or less2 – once a month or less3 – a few times a month4 – once a week5 – a few times a week6 – every day6b. I plan to prioritize my mental health and that of my colleagues by: Using an individual or team well-being plan.(Required)0 – never1 – a few times a year or less2 – once a month or less3 – a few times a month4 – once a week5 – a few times a week6 – every day6c. I plan to prioritize my mental health and that of my colleagues by: Reaching out to potentially struggling colleagues.(Required)0 – never1 – a few times a year or less2 – once a month or less3 – a few times a month4 – once a week5 – a few times a week6 – every day7a. Last week, I prioritized my mental health and that of my colleagues by: Treating my mental health as a vital sign and periodically assessing.(Required)0 – never1 – a few times a year or less2 – once a month or less3 – a few times a month4 – once a week5 – a few times a week6 – every day7b. Last week, I prioritized my mental health and that of my colleagues by: Using an individual or team well-being plan.(Required)0 – never1 – a few times a year or less2 – once a month or less3 – a few times a month4 – once a week5 – a few times a week6 – every day7c. Last week, I prioritized my mental health and that of my colleagues by: Reaching out to potentially struggling colleagues.(Required)0 – never1 – a few times a year or less2 – once a month or less3 – a few times a month4 – once a week5 – a few times a week6 – every day
