Document Control
| Field | Value |
|---|---|
| Document Title | Mental Wellness Self-Check Form |
| Document Owner | Human Resources |
| Version | 1.0 |
| Effective Date | {{effective_date}} |
| Review Cycle | Annual |
| Classification | Internal Use |
Purpose & Scope
Provide a private, structured way for employees to reflect on wellbeing and identify support needs early.
How are you feeling?
| Dimension | Score (1–5) |
|---|---|
| Energy | |
| Sleep Quality | |
| Mood | |
| Focus | |
| Connection with Team | |
| Workload Manageability |
Signals to Watch
What would help?
Resources
- Employee Assistance Programme: {{eap_contact}}
- Mental Health First Aiders: {{mhfa_list}}
- Crisis lines: {{crisis_lines}}
Confidentiality & Data Protection
All personal data captured under this document is processed in accordance with {{company_name}}'s Data Protection & Privacy Policy and applicable data-protection legislation (including GDPR/UK GDPR where relevant). Records are retained for {{retention_period}} and accessed only on a need-to-know basis.
Notes
Use this space to capture additional context, attachments referenced, or any deviations from standard process. All notes form part of the official record.
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