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Celebrating Gay Pride
Step 2 - Intake Survey

The following questions are the same ones that we used in the first Quality of Life Survey related to mental health levels. Your answers will be completely confidential and not connected to your personal file with either Essie’s Place or Our Landing Place. We will not be tracking any of your identifying information.

Quality of Life Survey
How safe do you feel in your daily life? (1 means feeling very unsafe, 5 means feeling extremely safe)
Do you have enough energy for your everyday life? (1 means feeling very low energy, 5 means feeling having more than enough energy)
Are you able to accept your bodily appearance? (1 means you can not accept your bodily appearance, 5 means you have a high level of acceptance)
How satisfied are you with your sleep? (1 means feeling highly unsatisfied, 5 means feeling extremely satisfied)
How satisfied are you with yourself? (1 means feeling highly unsatisfied, 5 means feeling extremely satisfied)
How often do you have negative feelings such as blue mood despair, anxiety, depression (1 means having these feelings very often, 5 means rarely having these feelings)
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