Active Well-being Participant Application
Student Information
Student ID *
Your answer
Full name (First and Last)
Your answer
Gender
Date of Birth
Your answer
Address
Your answer
Email
Your answer
Mobile number (we will text this number, you can opt out at any time)
Your answer
Course of study and year
Your answer
Ethnicity
Do you have any physical or mental health conditions or illnesses that have lasted or are expected to last 12 months or more?
Please tell us a bit about yourself
What are some of your interests?
Your answer
What course are you studying at the university?
Your answer
What is your favourite sport(s) from the list below
Warwick-Edinburgh Well-being Scale
Below are some statements about feelings and thoughts. Please tick the box that best describes your experience of each over the past two weeks. We'll ask you to complete this again after six sessions.
I've been feeling optimistic about the future
None of the time
All of the time
I've been feeling useful
None of the time
All of the time
I've been feeling relaxed
None of the time
All of the time
I've been feeling interested in other people
None of the time
All of the time
I've had energy to spare
None of the time
All of the time
I've been dealing with problems well
None of the time
All of the time
I've been thinking clearly
None of the time
All of the time
I've been feeling good about myself
None of the time
All of the time
I've been feeling close to other people
None of the time
All of the time
I've been feeling confident
None of the time
All of the time
I've been able to make up my own mind about things
None of the time
All of the time
I've been feeling loved
None of the time
All of the time
I've been interested in new things
None of the time
All of the time
I've been feeling cheerful
None of the time
All of the time
Well-being and Activity Scale
Below are a few questions and statements about well-being and activity. Please circle the answer that best describes your experience of each. We will ask you to complete this again after six sessions.
How much activity do you do in a week?
I enjoy taking part in exercises and sports
Strongly agree
Strongly disagree
I feel confident when I exercise and play sports
Strongly agree
Strongly disagree
I find exercise and sports easy
Strongly agree
Strongly disagree
I understand why exercise and sports are good for me
Strongly agree
Strongly disagree
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