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* 1. What is your name?

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* 2. Please confirm your email address

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* 3. How would you rate your current mental health?

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* 4. How would you rate the mental health of your child?

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* 5. How confident do you feel in your ability to support your child's mental health?

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* 6. How often do you practice self-compassion?

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* 7. How often do you practice self-care?

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* 8. How often do you experience anxiety related to your role as a parent-carer?

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* 9. How challenging do you find the shift from being a parent to being a carer?

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* 10. How satisfied are you with your current relationships with family and friends?

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* 11. How satisfied are you with your current relationships with yourself?

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* 12. What do you hope to gain from the Be Programme?

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* 13. Considering the last 6 months, on a scale of 1 - 10 stars (1 being extremely poor and 10 being excellent) please tell us how you rate your over-all mental wellbeing

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* 14. Considering the last 6 months, on a scale of 1 - 10 stars (1 being extremely poor and 10 being excellent) please tell us how you rate your over-all confidence

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* 15. Considering the last 6 months, on a scale of 1 - 10 stars (1 being extremely poor and 10 being excellent) please tell us how you rate your over-all happiness

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* 16. Please tell us in a single word how you feel about your own mental well-being today

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* 17. Aside from your child's mental health - what single thing would you like to change about your life?

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