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Free Fatigue and Mental Health Screening Assessment Template

A free, non-clinical fatigue and mental wellbeing initial-screening self-assessment that scores fatigue, stress, sleep and workload on a 1-5 scale and offers practical, supportive takeaways.

Assessment
~10 min
Customizable fields
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Quick answer

A free, non-clinical fatigue and mental wellbeing initial-screening self-assessment that scores fatigue, stress, sleep and workload on a 1-5 scale and offers practical, supportive takeaways.

Disclaimer: this page is for process reference and self-checking only. It does not constitute medical, psychological, financial, legal or safety advice. Consult a qualified professional when needed.

Methodology: items are a structural adaptation of widely used frameworks, not an official version; results are indicative, not diagnostic.

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About this template

This fatigue and wellbeing screening self-assessment is a supportive initial screen, not a diagnosis. Statements across fatigue, stress, sleep and workload are rated on a 1-5 scale, and the report gives gentle, practical suggestions and points to support resources.

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Live Preview

Sample form and AI report preview, fillable right in your browser.

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Fill it in to see how responses flow.
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Sample AI report with scoring visuals and recommendations, printable as a PDF.
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What's Included

Everything you need to run this template.

1

Purpose-built fields

Fatigue and Mental Health Screening Assessment ships with the exact fatigue and stress screening score fields practitioners ask for — no blank form to fill.

2

Yours to shape

Rename, reorder and rebrand every field to match your site and process.

3

One place to collect

Every response lands in a single dashboard you can review and export.

4

Personalized output

A branded, shareable AI PDF report generated per respondent.

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How It Works

From copy to deliverable in four steps.

1

Use this template

Copy the fatigue and mental health screening assessment into your FormLM workspace — free.

2

Match your process

Adjust fields, options and thresholds to your site, roles and standards.

3

Share and collect

Send the link or QR; every response is captured automatically.

4

Review and act

Open the personalized AI PDF report and share it with stakeholders.

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Who Is This For

Pick your role — see how it fits your workflow.

1

Operations managers

Standardise how you run fatigue and stress screening score — no rebuilding a blank form each time.

2

Teams & sites

Give every area and shift a consistent fatigue and stress screening score process with results in one dashboard.

3

Consultants & auditors

Deliver a branded fatigue and stress screening score record to each client you support.

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Key Features

What makes this template work as a professional deliverable.

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Sample Questions Inside

A preview of real questions — the full version adds scoring and a personalized report per respondent.

  1. I feel rested at the start of a shift (1-5)
  2. Workload feels manageable (1-5)
  3. I recognize rising stress early (1-5)
  4. I take effective breaks (1-5)
  5. Sleep supports my recovery (1-5)
  6. I know where to seek support (1-5)
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Frequently Asked Questions

Is this a mental-health diagnosis?
No — it is a non-clinical initial screen for reflection, not a diagnosis.
What does it measure?
Self-rated fatigue, stress, sleep and workload on a 1-5 scale.
Does it give guidance?
Yes, supportive, practical takeaways and a pointer to seek real help when needed.
Who is it for?
Workers and teams wanting an early, private wellbeing check-in.

Put this Fatigue and Mental Health Screening Assessment to work

Copy it, tailor the fields to your site and generate a personalized AI report per response — free to start.