Child Mental Wellness Questionnaire (Age: 11-17)
Thank you for taking the time to complete our questionnaire!



This questionnaire is designed for a child (11-17 years in age) to self-assess their mental health. If you do not meet this criteria or are a parent/guardian assessing your child (11-17 years in age), please complete the appropriate questionnaire from the list below.

- Adult Mental Wellness Questionnaire (Age: 18+):
- Parent/Guardian-Rated Child Mental Wellness Questionnaire (Age: 6-17):


The purpose of this questionnaire is to obtain an initial general assessment of an individual’s mental health. The response to each question should be from the individual - regarding their own perception of their mental health. These responses should not be given on behalf of the individual unless they have difficulty answering the question on their own. If you are submitting for an individual on their behalf it is with the understanding that you have full legal permissions to do so. The results of this questionnaire do not replace clinical evaluation or treatment but instead serve as a guide for individuals to better understand their mental condition. By completing and submitting this questionnaire you are consenting to the use of any data included for research purposes on behalf of IMHS.
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