1st question: Age = input answer

2nd question: Overall how would you rate your mental health?

5 options: excellent, somewhat good, average, somewhat poor, not sure

3rd question: After the incident, have you had any problems with your work or daily life due to your
mental health, such as feeling anxious, depressed, or sad?

3 options: yes, no, not sure

4th question: After the incident, how often has your mental health affected your ability to get work
done?

4 options: very often, somewhat often, not so often, not at all

5th question: After the incident, how often has your mental health affected your relationships?

4 options: very often, somewhat often, not so often, not at all

6th question: Have you noticed any change in your diet habits?

4 options: Yes, eat too much; Yes, I don’t feel hungry; not much; No change

7th question: Are you feeling nervous, anxious, or on edge

4 options: very often, somewhat often, not so often, not at all

8th question: Have you had trouble relaxing

4 options: very often, somewhat often, not so often, not at all

9th question: Feeling afraid, as if something awful might happen

4 options: very often, somewhat often, not so often, not at all

10th question: Have you seen a therapist in the recent past?

2 options: Yes; No

11th question: Are you currently taking any medication?

2 options: Yes; No

12th question: How many hours do you sleep per day?

4 Options: Less than 4 hours; 4-6; 7-9; 9+

13th question: How is your quality of sleep?

5 Options: Very bad; Bad; Normal; Good; Very Good

14th question: Do you want to share any other information? = input