Asking for HELP is a sign of COURAGE

Your Name*

Mobile Number

Email Address*

Which of the centre you study at?

Marol naka, Andheri

Kopar Khairane, Navi Mumbai

Tilak Nagar, Kurla East

Jui Nagar, Navi Mumbai

Andheri East (Nr. Railway station)

I am not currently enrolled with ShikshaGram

Do you want to keep this discussion private from your family and friends ?*

Yes

Not needed

Are you okay today*

Yes

Feeling better than yesterday

Do you love doing what you are doing?*

Yes Very much. I am loving it

My success will make my family happy

I am struggling with this but will surely improve from here

My life will be better without this

Are you feeling down or feeling hopelessness lately?

Not at all

Sometimes

For last few days

for last many weeks/months

How has been your sleep these days?

Able to sleep with ease

it takes some time to sleep

I have to struggle a bit before I fall asleep

It it very difficult for me to sleep

Which statement seems correct at the moment?

Life is fun and people around are fun too

Life is just a way to complete one's tasks

Life is a struggle and people are busy

Life is scary and lonely

How is your appetite

Its okay. I do not see any change

I feel I am gaining or loosing my weight a bit

I feel always hungry or fed. My cravings have increased or vanished

Feeling about life's failures always?

Not at all

Some times

More these days

Always

How do YOU feel your family without you?

Extremely sad

Sad a bit for a while

Unchanged. No one cares

Happy

Are you able to concentrate on reading your books or newspapers

Yes, very much

Somewhat

I face difficulty in focusing on anything

You feel something is worrying you constantly?

Not at all

Some times

Always

You want to write something here?*

This page has been created to seek PERSONAL HELP (particularly, mental health)

(Please do not post anything related to the Study Room's functioning and your good/bad experiences here)

Please take your own time in filling out this form. There is no haste, and I will wait for your answers.
Write your answers as if you are disclosing things with your most trusted friend/person.