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Please take a few moments to answer these 15 questions prior to your session.  It should take approximately only 2 minutes.  These questions are in direct relationship to how you are doing in regard to the “sheltering in place” order in Minnesota during the Coronavirus Pandemic and how you are doing today.  This data will hopefully be used to assess people’s mental status as we move through this unprecedented time.  If this data is used for any future publications, no names or identifying information will be included.  


Your participation is voluntary and will not impact your therapy in any way should you chose not to participate.  No adverse effects should occur, but if you feel dysregulated at any time, please address with your therapist during your session. You are free to discontinue your participation at any time.  However, we do ask that if you discontinue your participation, you do not resume.

By completing the assessments you are consenting to participation.

Thank you

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