Psychological Wellbeing Scale
22 reviews
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Use our readymade template to create your Psychological Wellbeing Scale (WBS) for assessing individual's well-being

Create your care assessments

Assessment form builder
  • navigate_next Prebuilt template with WBS scoring to assess the presence of psychological well-being and measure its severity
  • navigate_next 18-item questionnaire that scores each item as “1” (strongly disagree) to “7” (strongly agree)
  • navigate_next Real-time calculation of WBS Score and well-being severity based on the form responses
  • navigate_next Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
  • navigate_next Compare the scores from the initial screening with that of the followup to track the progression of psychological well-being
  • navigate_next Easily create responsive forms that allow patients to complete their assessments on any device at any time

Collect responses from your patients

Patient ID 1004
Patient Name John W
Patient Email johnw@ymail.com
Patient Phone Number 0987654321
Doctor's Name Dr. Smith
Location New York
1. I like most parts of my personality. Somewhat agree
2. When I look at the story of my life, I am pleased with how things have turned out so far. Strongly agree
3. Some people wander aimlessly through life, but I am not one of them. A little agree
4. The demands of everyday life often get me down. Neither agree or disagree
5. In many ways I feel disappointed about my achievements in life. A little disagree
6. Maintaining close relationships has been difficult and frustrating for me. Somewhat disagree
7. I live life one day at a time and don't really think about the future. Strongly disagree
8. In general, I feel I am in charge of the situation in which I live. Strongly agree
9. I am good at managing the responsibilities of daily life. Somewhat agree
10. I sometimes feel as if I've done all there is to do in life. A little agree
11. For me, life has been a continuous process of learning, changing, and growth. Neither agree or disagree
12. I think it is important to have new experiences that challenge how I think about myself and the world. A little disagree
13. People would describe me as a giving person, willing to share my time with others. Somewhat disagree
14. I gave up trying to make big improvements or changes in my life a long time ago Strongly disagree
15. I tend to be influenced by people with strong opinions. Strongly agree
16. I have not experienced many warm and trusting relationships with others. Somewhat agree
17. I have confidence in my own opinions, even if they are different from the way most other people think. A little agree
18. I judge myself by what I think is important, not by the values of what others think is important. Neither agree or disagree
Autonomy 16
Environmental Mastery 15
Personal Growth 14
Positive Relations with Others 13
Purpose in Life 12
Self-Acceptance 11
  • navigate_next Collect patient details such as patient id, name, email etc in the WBS assessment form
  • navigate_next Send an email invitation with a secure link for patients to complete their WBS assessment form prior to their visit
  • navigate_next Allow patients to save their progress and complete their WBS assessment form at a later time without losing any responses
  • navigate_next Set up an email template for your WBS assessment and automatically send invitation emails to multiple patients with ease
  • navigate_next Send a confirmation email to the patients with their WBS score, diagnosis, next steps when they submit their WBS assessment

Track patient responses in Google Sheets

A B C D E
1 Name Question Answer Score Total Score
2 John W 1. I like most parts of my personality. Somewhat agree 6 16
3 John W 2. When I look at the story of my life, I am pleased with how things have turned out so far. Strongly agree 7 16
4 John W 3. Some people wander aimlessly through life, but I am not one of them. A little agree 5 16
5 John W 4. The demands of everyday life often get me down. Neither agree or disagree 4 16
6 John W 5. In many ways I feel disappointed about my achievements in life. A little disagree 5 16
7 John W 6. Maintaining close relationships has been difficult and frustrating for me. Somewhat disagree 6 16
8 John W 7. I live life one day at a time and don't really think about the future. Strongly disagree 7 16
9 John W 8. In general, I feel I am in charge of the situation in which I live. Strongly agree 7 16
10 John W 9. I am good at managing the responsibilities of daily life. Somewhat agree 6 16
11 John W 10. I sometimes feel as if I've done all there is to do in life. A little agree 3 16
12 John W 11. For me, life has been a continuous process of learning, changing, and growth. Neither agree or disagree 4 16
13 John W 12. I think it is important to have new experiences that challenge how I think about myself and the world. A little disagree 3 16
14 John W 13. People would describe me as a giving person, willing to share my time with others. Somewhat disagree 2 16
15 John W 14. I gave up trying to make big improvements or changes in my life a long time ago Strongly disagree 7 16
16 John W 15. I tend to be influenced by people with strong opinions. Strongly agree 1 16
17 John W 16. I have not experienced many warm and trusting relationships with others. Somewhat agree 2 16
18 John W 17. I have confidence in my own opinions, even if they are different from the way most other people think. A little agree 5 16
19 John W 18. I judge myself by what I think is important, not by the values of what others think is important. Neither agree or disagree 4 16
  • navigate_next Export patient responses including the calculated WBS score and well-being severity to Google Sheets for easy record-keeping
  • navigate_next Export individual points for 18 items to Google Sheets for data manipulation and analysis for comprehensive insights
  • navigate_next Use pre-built reports to easily keep track of patient progress over time and monitor changes in their psychological well-being symptoms
  • navigate_next Receive a copy of the response and the calculated WBS score by email whenever a patient submits their WBS assessment
  • navigate_next Use data in Google Sheets to integrate with external EHR systems for seamless data transfer

HIPAA compliance

Patient ID: 1004
Patient Name: ******
Patient Email: ******
Patient Phone Number: ******
Doctor's Name: Dr. Smith
Location: New York
1. I like most parts of my personality.: Somewhat agree
2. When I look at the story of my life, I am pleased with how things have turned out so far.: Strongly agree
3. Some people wander aimlessly through life, but I am not one of them.: A little agree
4. The demands of everyday life often get me down.: Neither agree or disagree
5. In many ways I feel disappointed about my achievements in life.: A little disagree
6. Maintaining close relationships has been difficult and frustrating for me.: Somewhat disagree
7. I live life one day at a time and don't really think about the future.: Strongly disagree
8. In general, I feel I am in charge of the situation in which I live.: Strongly agree
9. I am good at managing the responsibilities of daily life.: Somewhat agree
10. I sometimes feel as if I've done all there is to do in life.: A little agree
11. For me, life has been a continuous process of learning, changing, and growth.: Neither agree or disagree
12. I think it is important to have new experiences that challenge how I think about myself and the world.: A little disagree
13. People would describe me as a giving person, willing to share my time with others.: Somewhat disagree
14. I gave up trying to make big improvements or changes in my life a long time ago: Strongly disagree
15. I tend to be influenced by people with strong opinions.: Strongly agree
16. I have not experienced many warm and trusting relationships with others.: Somewhat agree
17. I have confidence in my own opinions, even if they are different from the way most other people think.: A little agree
18. I judge myself by what I think is important, not by the values of what others think is important.: Neither agree or disagree
Autonomy: 16
Environmental Mastery: 15
Personal Growth: 14
Positive Relations with Others: 13
Purpose in Life: 12
Self-Acceptance: 11
Autonomy: 16
  • navigate_next Create a HIPAA compliant WBS assessment form to safely collect, store and access patient responses
  • navigate_next Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
  • navigate_next Automatically mask PHI fields when exporting WBS form responses to Google Sheets and sending them on email
  • navigate_next Prepopulate patient details in WBS assessments by creating secure prefill links without exposing PHI
  • navigate_next Limit access to patient data only for authorized personnel and minimize the risk of data breaches

These reviews are reproduced without modification from Google Workspace Marketplace.

July 27, 2023

5 stars

I am 100% a fan of this company. We use HIPAA compliant Google Forms and needed a way to collect signatures, the industry standard company is TOO expensive. I started using FormEsign and it worked perfectly. It lacked the ability to provide a pdf copy of the form after signature. This company worked with me help their product evolve into something that could benefit all future clients AND the end user. The team was polite, professional, kind, enthusiastic, and willing to make a change. This earned my loyalty. I will sing their praises. Good work, and thank you!

— Royal Bush

July 23, 2023

5 stars

I am not tech savvy. I chose formesign to help create registration links for clients. Vipid has been great in assisting me. He goes above and beyond. My company now has moved from the stone age to modern age through the ability to use this feature. Of the many features I am impressed with, the ability to update a form without needing to regenerate a link is amazing. I often make mistakes and that ability allows me to fix mistakes without needing to change everything. Thank you!!!

— Sol Evans

February 16, 2024

1 stars

Does not work

— Myles Sicuro

October 31, 2023

5 stars

We needed a way to create forms with e-signatures and this app made it very easy. Support is also very quick and always helpful. Cannot recommend enough!

— Chris Henesy

July 12, 2023

5 stars

It very friendly to used. I love it. For my case multiple signature needed. it's supporting

— Senthil Kumar

November 27, 2023

5 stars

Yeah this is good for all

— luqman khan

July 10, 2023

5 stars

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