Template library · Assessments & screeners
Wellbeing Check-In template
Rate your agreement with each statement about your current wellbeing.
Positive-framed wellbeing self-report
- 16 fields across 3 sections
- Included with MyWellOps
- Edit it, or save your own version
What’s in it
Assessment Details
- Client NameText
- Date of BirthDate
- Client ID / MRNText
- Date of AssessmentDate
- Clinician / CoachText
- Location / ModalityText
Wellbeing Statements
- 1. I feel able to cope with daily demandsChoice
- 2. I have people I can rely on for supportChoice
- 3. I feel a sense of purpose in my lifeChoice
- 4. I am generally satisfied with my lifeChoice
- 5. I feel emotionally stableChoice
- 6. I take time to care for myselfChoice
Signatures
- Clinician SignatureSignature
- Date signed (clinician)Date
- Client SignatureSignature
- Date signed (client)Date
When to use it
Use an assessment at the start of work to set a baseline, then repeat it at review points so you and the client can see what has changed.
How it works in MyWellOps
- Pick it from Documents.
- Send it to the client to complete, or fill it in together during a session.
- Each completed copy is kept on the client’s record, so earlier results are there to compare.
Spend less time on admin, more time with clients
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