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* 1. Your gender:

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* 2. Your Age:

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* 3. Write 5 words that you associate with well-being:

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* 4. When you feel unwell what do you feel like doing the most?

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* 5. Specify you previous answer (think about where, type, how, with whom):

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* 6. What are habits that emerge when you're feeling unwell? (i.e. fidgeting, smoking, carelessness)

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* 7. What is the main reason you would feel unwell nowadays?

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* 8. When you are unwell how do you try to be well again?

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