Mental Health Check-in Survey Template
Validated PHQ-2 and GAD-2 mental health screener. Anonymous by default, HIPAA-aware, with safe EAP routing for elevated risk. Built for workplace wellbeing programs.
Interactive preview — for the best experience
For You
Why Use This Mental Health Check-in Survey Template?
Built and battle-tested by teams who collect real responses every day.
Validated PHQ-2 and GAD-2 Items
Opens with the two-item PHQ-2 (depression) and GAD-2 (anxiety) screeners from Kroenke et al. — the clinically validated short forms used in primary care. Optional expansion to full PHQ-9 / GAD-7 when risk is elevated.
Anonymous by Default, Always
Zero-identifier mode is on by default — no IP logging, no browser fingerprint, no email required. Respondents see a clear anonymity notice before any question. Critical for honest disclosure on mental health topics.
How It Works
From template to live survey in three quick steps.
Fill Out the Survey
Try the survey yourself — every field is interactive. See how respondents will experience it.
Import to Poper
Click 'Use This Template' to load it into your Poper dashboard. Customize fields, styling, and logic.
Embed Anywhere
Add it to your website, landing page, or share as a standalone link. Responses stream straight into Poper.
For Teams & Businesses
Built for Professional Use
Import this survey into Poper, brand it, and embed it anywhere. Responses flow straight into your tools.
HIPAA-Aware, BAA Available
Signed Business Associate Agreement available on Business plans. Encrypted at rest with AES-256, TLS 1.3 in transit, and SOC 2 Type II controls — suitable for benefits, EAP, and occupational health use.
EAP & Resource Routing
Elevated risk scores (PHQ-2 ≥ 3 or GAD-2 ≥ 3) automatically surface EAP contact info, crisis line, or booking link — without exposing the response to the employer. Supports safe escalation pathways.
Trended Organizational Wellbeing
Aggregate scores by department, tenure, or location — never by individual. K-anonymity threshold ensures no segment below 10 responses is reported. HR gets wellbeing trends without surveillance risk.
Perfect for:
Ready to launch your mental health check-in survey template?
Import this template into Poper, customize it with your own questions and branding, and embed it on your website in minutes.
FAQs
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