Combined GDS/GAS Pre Assessment

Full Name

Email

Assessment Date

Programme

Are you basically satisfied with your life?

Yes No

Have you dropped many of your activities and interests?

Yes No

Do you feel that your life is empty?

Yes No

Do you often get bored?

Yes No

Are you in good spirits most of the time?

Yes No

Are you afraid something bad will happen?

Yes No

Do you feel happy most of the time?

Yes No

Do you often feel helpless?

Yes No

Do you prefer to stay at home?

Yes No

Do you feel you have more memory problems?

Yes No

Do you think it is wonderful to be alive now?

Yes No

Do you feel worthless?

Yes No

Do you feel full of energy?

Yes No

Do you feel hopeless?

Yes No

Do you think others are better off than you?

Yes No