Free Screening

Take the First Step Privately

This is not a diagnosis. It helps our team understand what kind of support may be useful before we reach out.

Step 1 of 6
Your situation

Who is this screening for?

What are the main concerns?

Select all that apply

For follow-up conversations
Helps us avoid duplicating existing care
Optional — anything that might help us understand your situation better

Over the last 2 weeks, how often have you experienced the following? There are no right or wrong answers.

Little interest or pleasure in doing things

Feeling down, depressed, or hopeless

Trouble falling or staying asleep, or sleeping too much

Feeling tired or having little energy

Poor appetite or overeating

Feeling bad about yourself or that you have let people down

Trouble concentrating on work, school, reading, or media

Moving or speaking slowly, or being unusually restless

Thoughts that you would be better off dead or of hurting yourself

Feeling nervous, anxious, or on edge

Not being able to stop or control worrying

Worrying too much about different things

Trouble relaxing

Being so restless that it is hard to sit still

Becoming easily annoyed or irritable

Feeling afraid as if something awful might happen

These questions help us understand if focus or attention might be playing a role. Answer honestly — this is just a starting point.

Trouble wrapping up final details once the challenging part is done

Difficulty getting things in order when a task requires organization

Problems remembering appointments, obligations, or important tasks

Avoiding or delaying tasks that require a lot of thought

Fidgeting or squirming when expected to sit still

Feeling overly active, restless, or driven to keep moving

Sleep problems are affecting daily life

Alcohol or substance use is becoming a concern

Past traumatic events still feel distressing or intrusive

Panic attacks or sudden intense fear are happening

Let us know how to reach you. Your details stay confidential.

We’ll use this to send you a copy of your responses
e.g. +254 712 345 678 or 0712345678
How should we reach out to you?
Optional but recommended

You’ve completed every section. Confirm consent below and submit — we’ll share what your responses suggest right after.

If you selected an immediate safety risk, please contact emergency services now. This website form is not monitored as an emergency channel.