Questionnaire

Name

First NameLast Name

Address

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CityState / Province

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Telephone

Email

How do you feel your mental health is?

What do you do when you have pressing concerns of big problems you your experiencing?

Do you feel at times you feel low? What do you do when you feel this way?

Have you got hobbies or activities you do to calm yourself or making yourself feel better?

Do you know where to go to when you feel you need to talk to someone?

Do you have a big network of people you can go to when you are having problems?

Do you feel you have someone looking out for you?

Can you talk to other men? Or do you go to women in your life to talk about issues that affect you?

Do you mediate, self-reflect or do anything that helps you get to a better place mentally?

Do you think it is easier for women to get help, than men?

Do you know of men who have struggled with Mental health?

Do you know of men in your circle who have committed suicide?

Do you think men know signs of deteriorating mental health? Or depression?

Questions