Student Wellbeing Check-in
A gentle, non-intrusive wellbeing check-in designed for educational institutions. This form helps track student mood, energy levels, stress, sleep quality, and social connection. Smart conditional logic shows supportive resources when students indicate they're struggling, while celebrating positive responses. Perfect for regular pulse checks throughout the academic term.
Try the Form
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export function studentWellbeing(form: FormTs) {
// Student Wellbeing Check-in - Supportive mental health tracking
// Demonstrates: EmojiRating, Slider, ThumbRating, dynamic styling, conditional support resources
// ============================================
// HEADER
// ============================================
form.addRow(row => {
row.addTextPanel('header', {
label: 'Wellbeing Check-in',
computedValue: () => "Let's check in on how you're doing. Your responses are confidential and help us support you better.",
customStyles: {
background: 'linear-gradient(135deg, #10b981 0%, #059669 100%)',
color: 'white',
padding: '24px',
borderRadius: '16px',
textAlign: 'center'
}
});
});
// ============================================
// SECTION 1: Emotional State
// ============================================
const moodSection = form.addSubform('emotionalState', {
title: 'How Are You Feeling?',
customStyles: { backgroundColor: '#f0fdf4', padding: '16px', borderRadius: '12px' }
});
moodSection.addRow(row => {
row.addEmojiRating('currentMood', {
label: 'How would you describe your mood right now?',
preset: 'mood',
size: 'lg',
showLabels: true,
alignment: 'center',
isRequired: true
});
});
// Dynamic response based on mood
moodSection.addRow(row => {
row.addTextPanel('moodResponse', {
computedValue: () => {
const mood = moodSection.emojiRating('currentMood')?.value();
if (!mood) return '';
const responses: Record<string, string> = {
'sad': "I'm sorry you're feeling down. It's okay to have difficult days. Let's continue and see how we can help.",
'down': "Thanks for sharing. Everyone has ups and downs - acknowledging how you feel is an important first step.",
'neutral': "Thanks for checking in. Let's see how things are going overall.",
'happy': "That's wonderful to hear! Let's capture what's going well.",
'excited': "Amazing! It's great that you're feeling so positive!"
};
return responses[mood] || '';
},
isVisible: () => moodSection.emojiRating('currentMood')?.value() !== null,
customStyles: () => {
const mood = moodSection.emojiRating('currentMood')?.value();
const base = { padding: '12px', borderRadius: '8px', fontStyle: 'italic', textAlign: 'center' };
if (mood === 'sad' || mood === 'down') {
return { ...base, backgroundColor: '#fef3c7', color: '#92400e' };
}
if (mood === 'happy' || mood === 'excited') {
return { ...base, backgroundColor: '#d1fae5', color: '#065f46' };
}
return { ...base, backgroundColor: '#f1f5f9', color: '#475569' };
}
});
});
// ============================================
// SECTION 2: Energy & Physical Wellbeing
// ============================================
const physicalSection = form.addSubform('physicalWellbeing', {
title: 'Energy & Physical Wellbeing'
});
physicalSection.addRow(row => {
row.addSlider('energyLevel', {
label: 'What is your energy level today?',
min: 1,
max: 10,
step: 1,
defaultValue: 5,
showValue: true
});
});
physicalSection.addRow(row => {
row.addTextPanel('energyLabel', {
computedValue: () => {
const energy = physicalSection.slider('energyLevel')?.value() ?? 5;
if (energy <= 3) return '😴 Low energy - that\'s tough';
if (energy <= 6) return '😐 Moderate energy';
if (energy <= 8) return '😊 Good energy!';
return '⚡ Full of energy!';
},
customStyles: { textAlign: 'center', fontSize: '14px', color: '#64748b' }
});
});
physicalSection.addRow(row => {
row.addSlider('sleepQuality', {
label: 'How well did you sleep last night?',
min: 1,
max: 10,
step: 1,
defaultValue: 5,
showValue: true
}, '1fr');
row.addSlider('sleepHours', {
label: 'Hours of sleep',
min: 0,
max: 12,
step: 0.5,
defaultValue: 7,
unit: 'hrs',
showValue: true
}, '1fr');
});
// Low sleep warning
physicalSection.addRow(row => {
row.addTextPanel('sleepWarning', {
computedValue: () => '💡 Tip: Try to aim for 7-9 hours of sleep for optimal wellbeing.',
isVisible: () => {
const hours = physicalSection.slider('sleepHours')?.value() ?? 7;
return hours < 6;
},
customStyles: { backgroundColor: '#fef3c7', padding: '12px', borderRadius: '8px', color: '#92400e' }
});
});
// ============================================
// SECTION 3: Stress & Academic Pressure
// ============================================
const stressSection = form.addSubform('stressLevel', {
title: 'Stress & Academic Pressure'
});
stressSection.addRow(row => {
row.addSlider('stressLevel', {
label: 'How stressed are you feeling?',
min: 1,
max: 10,
step: 1,
defaultValue: 5,
showValue: true
});
});
stressSection.addRow(row => {
row.addTextPanel('stressIndicator', {
computedValue: () => {
const stress = stressSection.slider('stressLevel')?.value() ?? 5;
if (stress <= 3) return '🌿 Low stress - great!';
if (stress <= 5) return '⚖️ Manageable stress';
if (stress <= 7) return '⚠️ Elevated stress';
return '🚨 High stress - please consider reaching out for support';
},
customStyles: () => {
const stress = stressSection.slider('stressLevel')?.value() ?? 5;
const base = { padding: '12px', borderRadius: '8px', textAlign: 'center' };
if (stress <= 3) return { ...base, backgroundColor: '#d1fae5', color: '#065f46' };
if (stress <= 5) return { ...base, backgroundColor: '#f1f5f9', color: '#475569' };
if (stress <= 7) return { ...base, backgroundColor: '#fef3c7', color: '#92400e' };
return { ...base, backgroundColor: '#fee2e2', color: '#991b1b' };
}
});
});
// Stress sources (conditional for higher stress)
stressSection.addRow(row => {
row.addCheckboxList('stressSources', {
label: 'What is contributing to your stress?',
options: [
{ id: 'exams', name: 'Upcoming exams or tests' },
{ id: 'assignments', name: 'Assignment deadlines' },
{ id: 'workload', name: 'Heavy workload' },
{ id: 'grades', name: 'Worrying about grades' },
{ id: 'social', name: 'Social pressures' },
{ id: 'family', name: 'Family issues' },
{ id: 'finances', name: 'Financial concerns' },
{ id: 'health', name: 'Health concerns' },
{ id: 'future', name: 'Worrying about the future' },
{ id: 'other', name: 'Other' }
],
orientation: 'vertical',
isVisible: () => (stressSection.slider('stressLevel')?.value() ?? 5) >= 5
});
});
// ============================================
// SECTION 4: Social Connection
// ============================================
const socialSection = form.addSubform('socialConnection', {
title: 'Social Connection'
});
socialSection.addRow(row => {
row.addEmojiRating('socialConnection', {
label: 'How connected do you feel to friends and peers?',
preset: 'satisfaction',
size: 'md',
alignment: 'center'
});
});
socialSection.addRow(row => {
row.addThumbRating('hasSupport', {
label: 'Do you have someone you can talk to when things get tough?',
showLabels: true,
upLabel: 'Yes, I have support',
downLabel: 'No, I feel alone',
alignment: 'center'
});
});
// Loneliness support (conditional)
socialSection.addRow(row => {
row.addTextPanel('supportInfo', {
computedValue: () => "You're not alone. Here are some resources that can help:\n\n📞 Campus Counseling: [Your Number]\n💬 Peer Support Chat: [Your Link]\n🤝 Student Support Groups: [Your Info]",
isVisible: () => socialSection.thumbRating('hasSupport')?.value() === 'down',
customStyles: {
backgroundColor: '#eff6ff',
padding: '16px',
borderRadius: '8px',
borderLeft: '4px solid #3b82f6',
whiteSpace: 'pre-wrap',
color: '#1e40af'
}
});
});
// ============================================
// SECTION 5: Overall Wellbeing
// ============================================
const overallSection = form.addSubform('overallWellbeing', {
title: 'Overall Wellbeing'
});
overallSection.addRow(row => {
row.addRatingScale('lifeSatisfaction', {
label: 'Overall, how satisfied are you with your life right now?',
preset: 'satisfaction',
alignment: 'center'
});
});
overallSection.addRow(row => {
row.addRadioButton('comparedLastWeek', {
label: 'Compared to last week, how are you doing?',
options: [
{ id: 'much-better', name: 'Much better' },
{ id: 'better', name: 'A bit better' },
{ id: 'same', name: 'About the same' },
{ id: 'worse', name: 'A bit worse' },
{ id: 'much-worse', name: 'Much worse' }
],
orientation: 'horizontal'
});
});
// ============================================
// SECTION 6: Needs & Support
// ============================================
const needsSection = form.addSubform('needsSupport', {
title: 'Your Needs'
});
needsSection.addRow(row => {
row.addThumbRating('needsSupport', {
label: 'Would you like to speak with someone about how you are feeling?',
showLabels: true,
upLabel: 'Yes, please',
downLabel: 'No, I am okay',
alignment: 'center'
});
});
// Support request details
const supportRequestSection = needsSection.addSubform('supportRequest', {
title: 'Support Request',
isVisible: () => needsSection.thumbRating('needsSupport')?.value() === 'up',
customStyles: { backgroundColor: '#eff6ff', padding: '16px', borderRadius: '8px' }
});
supportRequestSection.addRow(row => {
row.addCheckboxList('supportType', {
label: 'What kind of support would be most helpful?',
options: [
{ id: 'counseling', name: 'Talk to a counselor' },
{ id: 'academic', name: 'Academic support/tutoring' },
{ id: 'peer', name: 'Connect with peer support' },
{ id: 'resources', name: 'Learning about mental health resources' },
{ id: 'accommodations', name: 'Academic accommodations' }
],
orientation: 'vertical'
});
});
supportRequestSection.addRow(row => {
row.addTextbox('preferredContactTime', {
label: 'Best time to contact you',
placeholder: 'e.g., Afternoons, After 3pm'
});
});
// Open sharing
needsSection.addSpacer({ height: '16px' });
needsSection.addRow(row => {
row.addTextarea('anythingElse', {
label: 'Is there anything else you want to share?',
placeholder: 'Feel free to share anything on your mind...',
rows: 4,
autoExpand: true
});
});
// ============================================
// SECTION 7: Contact (Optional)
// ============================================
const contactSection = form.addSubform('contactInfo', {
title: 'Contact Information (Optional)',
isVisible: () => needsSection.thumbRating('needsSupport')?.value() === 'up'
});
contactSection.addRow(row => {
row.addTextbox('studentName', {
label: 'Your name',
placeholder: 'First and last name'
}, '1fr');
row.addEmail('studentEmail', {
label: 'Email address',
placeholder: 'your@email.edu'
}, '1fr');
});
// ============================================
// SECTION 8: Wellbeing Summary
// ============================================
const summarySection = form.addSubform('summary', {
title: 'Your Wellbeing Summary',
isVisible: () => moodSection.emojiRating('currentMood')?.value() !== null
});
summarySection.addRow(row => {
row.addTextPanel('summaryContent', {
computedValue: () => {
const mood = moodSection.emojiRating('currentMood')?.value();
const energy = physicalSection.slider('energyLevel')?.value() ?? 5;
const sleep = physicalSection.slider('sleepHours')?.value() ?? 7;
const stress = stressSection.slider('stressLevel')?.value() ?? 5;
const satisfaction = overallSection.ratingScale('lifeSatisfaction')?.value();
if (!mood) return '';
const moodLabels: Record<string, string> = {
'sad': '😢 Struggling',
'down': '😔 Feeling down',
'neutral': '😐 Neutral',
'happy': '😊 Doing well',
'excited': '🤩 Feeling great'
};
let summary = '📊 Wellbeing Snapshot\n';
summary += `${'═'.repeat(22)}\n\n`;
summary += `Mood: ${moodLabels[mood] || mood}\n`;
summary += `Energy: ${energy}/10\n`;
summary += `Sleep: ${sleep} hours\n`;
summary += `Stress: ${stress}/10\n`;
if (satisfaction) {
summary += `Life Satisfaction: ${satisfaction}/5`;
}
// Calculate overall wellbeing score
const wellbeingScore = Math.round((
(energy / 10) * 25 +
(Math.min(sleep, 8) / 8) * 25 +
((10 - stress) / 10) * 25 +
((satisfaction || 3) / 5) * 25
));
summary += `\n\n🎯 Overall Wellbeing: ${wellbeingScore}%`;
return summary;
},
customStyles: () => {
const stress = stressSection.slider('stressLevel')?.value() ?? 5;
const mood = moodSection.emojiRating('currentMood')?.value();
const base = {
padding: '16px',
borderRadius: '12px',
whiteSpace: 'pre-wrap',
fontFamily: 'monospace',
fontSize: '14px'
};
// Determine color based on overall state
if ((mood === 'sad' || mood === 'down') || stress >= 8) {
return { ...base, backgroundColor: '#fee2e2', borderLeft: '4px solid #ef4444' };
}
if (mood === 'happy' || mood === 'excited') {
return { ...base, backgroundColor: '#d1fae5', borderLeft: '4px solid #10b981' };
}
return { ...base, backgroundColor: '#f1f5f9', borderLeft: '4px solid #64748b' };
}
});
});
// Crisis resources (always visible at bottom)
form.addRow(row => {
row.addTextPanel('crisisInfo', {
label: 'Need immediate help?',
computedValue: () => 'If you are in crisis or having thoughts of self-harm, please reach out immediately:\n📞 Crisis Hotline: 988 (Suicide & Crisis Lifeline)\n💬 Crisis Text Line: Text HOME to 741741',
customStyles: {
backgroundColor: '#fef2f2',
padding: '16px',
borderRadius: '8px',
borderLeft: '4px solid #dc2626',
whiteSpace: 'pre-wrap',
fontSize: '13px',
color: '#7f1d1d'
}
});
});
// ============================================
// FORM CONFIGURATION
// ============================================
form.configureSubmitButton({
label: 'Submit Check-in',
isVisible: () => moodSection.emojiRating('currentMood')?.value() !== null
});
form.configureCompletionScreen({
type: 'text',
title: 'Thank You for Checking In!',
message: 'Taking time to reflect on your wellbeing is an important step. Remember, support is always available when you need it. Take care of yourself!'
});
}
Frequently Asked Questions
How often should we send this check-in?
Weekly check-ins work best for maintaining regular contact without causing survey fatigue. Consider more frequent check-ins during high-stress periods like exams, or less frequent (bi-weekly) during breaks.
Is this form appropriate for younger students?
The emoji-based design makes it accessible for students of all ages. For younger students, you may want to simplify some questions or add parental consent options. The visual emoji ratings are particularly effective for elementary and middle school students.
How do I respond to concerning answers?
The form includes conditional messaging that shows support resources when students indicate distress. For institutions, we recommend having a protocol in place for following up with students who consistently report low wellbeing scores.
Can students submit anonymously?
Yes, the contact section is optional. However, for effective support, you may want to encourage identification. Some institutions use a hybrid approach where wellbeing data is anonymized for trend analysis but identified for individual support.
What wellbeing dimensions does this form cover?
The form covers five key dimensions: emotional state (mood), physical wellbeing (energy, sleep), academic stress, social connection, and overall life satisfaction. Each dimension uses appropriate rating scales for quick completion.
Can I customize the support resources shown?
Absolutely. The conditional support section can be customized with your institution's specific resources - counseling services, hotlines, peer support groups, and online resources. Update the TextPanel content to include your specific contact information.