Registration: Prioritizing Mental Health

1. Role(Required)

2. Gender(Required)

Questions 3 and 4(Required)

	0 – never	1 – a few times a year or less	2 – once a month or less	3 – a few times a month	4 – once a week	5 – a few times a week	6 – every day
3. I feel burned out by my work
4. I have become more callous towards people since I took this job

5. How would you rate your mental health?(Required)

(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 – never	1 – a few times a year or less	2 – once a month or less	3 – a few times a month	4 – once a week	5 – a few times a week	6 – every day
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
6b. I plan to prioritize my mental health and that of my colleagues by: Using an individual or team well-being plan.
6c. I plan to prioritize my mental health and that of my colleagues by: Reaching out to potentially struggling colleagues.
7a. Last week, I prioritized my mental health and that of my colleagues by: Treating my mental health as a vital sign and periodically assessing.
7b. Last week, I prioritized my mental health and that of my colleagues by: Using an individual or team well-being plan.
7c. Last week, I prioritized my mental health and that of my colleagues by: Reaching out to potentially struggling colleagues.