People have faced many challenges over the past few months. Please read the following questions and answer them as honestly as possible.

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* 1. What is your name (This is optional)?

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* 2. What is your age?

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* 3. Have you lost your job due to the covid-19 pandemic?

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* 4. Have you suffered financially due to the covid-19 pandemic?

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* 5. Have you struggled with social isolation?

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* 6. Have you noticed an increase in your consumption of Drugs and or Alcohol?

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* 7. Can you afford to pay club fees etc to return to regular club activities?

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* 8. Do you feel anxious about returning to group activities including contact/non contact sport?

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* 9. Have you contacted any Help Lines during the Covid-19 Pandemic?

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* 10. These questions concern how you have been feeling over the past 30 days. 
During the last 30 days how often did you feel tired out for no good reason?

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* 11. During the last 30 days how often did you feel nervous?

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* 12. During the last 30 days how often did you feel so nervous that nothing could calm you down?

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* 13. During the last 30 days how often did you feel hopeless?

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* 14. During the last 30 days how often did you feel restless or fidgety?

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* 15. During the last 30 days how often did you feel so restless that you could not sit still?

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* 16. During the last 30 days how often did you feel depressed? 

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* 17. During the last 30 days how often did you feel that everything was an effort? 

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* 18. During the last 30 days how often did you feel so sad that nothing could cheer you up?

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* 19. During the last 30 days how often did you feel worthless?

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