Loneliness and Social Dissatisfaction Questionnaire

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Loneliness and Social Dissatisfaction Questionnaire

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*Q1. Your name (this will be attached to a person's response when the survey is completed anonymously)

*Q2. What’s been happening? Share a relaxed anecdote, case study or recent success.

*Q3. Date the activity actually happened

Q4. I have nobody to talk to (single choice)

Question Settings ▼ ▲

Always true True most of the times Sometimes true Hardly ever true Not true at all
1 2 3 4 5

Dropdown List used: I have nobody to talk to

Q5. I feel alone (single choice)

Question Settings ▼ ▲

Agree Disagree Neutral

Dropdown List used: I feel alone

Q6. I've been feeling relaxed: (single choice)

Question Settings ▼ ▲

1 2 3 4 5
1 2 3 4 5

Dropdown List used: I think good things will happen in my life

Q7. I've been getting on well with people (single choice)

Question Settings ▼ ▲

1 2 3 4 5
1 2 3 4 5

Dropdown List used: I think good things will happen in my life

Q8. I enjoy what each new day brings (single choice)

Question Settings ▼ ▲

1 2 3 4 5
1 2 3 4 5

Dropdown List used: I think good things will happen in my life

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