Hey there.
This form is a Pre-diagnostic tool (screening tool) to help you identify the level of stress or mental health dip that you might be experiencing (or have experienced) recently. The form is not intended as a formal diagnosis, but is aimed at helping you know if you need to seek professional advice.
The form is divided into 8 sections and should not take more than 15 mins to fill.

Some of the statements may not appear to be connected with mental health or stress. Try not to think of what each statement might indicate. Mental health conditions or stress shows up as a cluster of symptoms and no single experience can help us know our mental health status. Your responses are analysed through standardized criteria.

Once you complete the form, we will let you know if you need urgent professional help though an email which you will receive within 48 hours of submission.

All your data will be maintained through our strict data privacy policy, and is stored with utmost confidentiality and protection. We will never share or use your data beyond the screening requirement without your consent.
This form supports the campaign to help you decide if our CBT App, Pebbles - Better Thinking Habit is a suitable intervention for you. The suggestions are not intended to substitute professional help. We hope that the findings help you make an early and appropriate decision for better mental well-being.
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Email *
Name of the lead psychologist assisting for the screening data entry. Write 'NA' if you are filling the form for yourself. *
Full name (your first name will be used to address you in your email report) *
Gender *
Country *
Date of birth *
Email Id on which we can send your report *
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