Student Wellbeing and Health Access Screening Survey

Thanks for taking a few minutes for this wellbeing check-in. It's confidential and not a diagnosis — it just helps us understand how students are doing and where to put more support. About 5-6 minutes. If you're in crisis right now, please contact (Replace with your campus crisis line / emergency number) instead of continuing this survey.

On an average night over the past 2 weeks, about how many hours of sleep did you get?

Overall, how would you rate your physical health right now?

In the last 2 weeks, how often have you experienced each of the following?

In the last 30 days, how often did you skip meals because of lack of time or money?

• Never
• Once or twice
• About weekly
• Several times a week
• Almost every day

In the last 6 months, what has made it harder to get health support when you needed it? Select all that apply.

• Not enough time
• Cost or insurance concerns
• Didn't know where to go on campus
• Long wait times for appointments
• Worried about privacy or being judged
• Didn't think my concern was serious enough

Thinking about your own health over the past semester, which of these would you most and least want more support with?

• Managing stress and anxiety
• Getting enough sleep
• Eating regular, balanced meals
• Staying physically active
• Reducing alcohol or substance use
• Managing an ongoing physical health condition
• Feeling connected to other people
• Navigating campus health services

Have you spoken with any health professional (campus or otherwise) about your physical or mental health in the last 6 months?

• Yes, campus health or counseling
• Yes, an outside provider
• No, but I've thought about it
• No

Gently explore the single wellbeing area the respondent flagged as their top priority in the trade-off question (or the most frequent struggle from the earlier statements) — ask what it looks like day to day, what has made it harder or easier lately, and what kind of support would actually feel useful to them. If the respondent expresses anything suggesting self-harm risk or a health emergency, do not attempt to counsel them: calmly acknowledge it, avoid probing further on that thread, and clearly point them to (Replace with your campus crisis line / emergency contact).

What year are you in school? (Prefer not to say is fine)

• First year
• Second year
• Third year
• Fourth year
• Fifth year or beyond
• Graduate student
• Prefer not to say

Where do you currently live?

• On-campus housing
• Off-campus, near campus
• Off-campus, with family
• Off-campus, elsewhere
• Prefer not to say

Which best describes your gender identity?

• Woman
• Man
• Non-binary
• Prefer to self-describe
• Prefer not to say

Thank you for sharing this — it takes trust to be honest about health. Your responses will be combined with others (never shared individually) to help direct resources and outreach where students need them most.