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Questions marked with a * are required Exit Survey
 
 
* I was bothered by things that usually don't bother me
 
Rarely or none of the time
 
Some of little of the time
 
Occasionally or a moderate amount of the time
 
Most or all of the time
 
 
 
* I had trouble keeping my mind on what I was doing
 
Rarely or none of the time
 
Some of little of the time
 
Occasionally or a moderate amount of the time
 
Most or all of the time
 
 
 
* I felt depressed
 
Rarely or none of the time
 
Some of little of the time
 
Occasionally or a moderate amount of the time
 
Most or all of the time
 
 
 
* I felt that everything I did was an effort
 
Rarely or none of the time
 
Some of little of the time
 
Occasionally or a moderate amount of the time
 
Most or all of the time
 
 
 
* I felt hopeful about the future
 
Rarely or none of the time
 
Some of little of the time
 
Occasionally or a moderate amount of the time
 
Most or all of the time
 
 
 
* I felt fearful
 
Rarely or none of the time
 
Some of little of the time
 
Occasionally or a moderate amount of the time
 
Most or all of the time
 
 
 
* My sleep was restless
 
Rarely or none of the time
 
Some of little of the time
 
Occasionally or a moderate amount of the time
 
Most or all of the time