This private form is for any young person in Newport under 19 years of age who wants to see a counsellor.
**Please do not complete on behalf of a young person**
This part of the survey uses a table of questions,
The following questions are about how you have been feeling OVER THE LAST TWO WEEKS. Please read each question carefully. Think how often you have felt like that in the last week and then tick the box you think fits best.
I have read and agree to the privacy notice