Student mental health check form template is designed for school psychologists, counselors, and educators to quickly assess student wellbeing and identify needs. Use this form for routine check-ins, early screening, or follow-up after an incident.

This free template collects basic identifiers like name and student number, and uses simple, age-appropriate multiple-choice scales to evaluate sleep, meals, mood, and out-of-school circumstances. It also includes an open-ended prompt for students to share anything they want to report, enabling staff to capture both quantitative trends and personal concerns.

Ideal for in-person or remote use, the form works on mobile devices and can be embedded on a website or shared via link. No coding is required — add your logo, adjust questions, and review responses in real time so counselors can prioritize outreach and interventions.

Click "Use This Template" to start customizing and deploying the student mental health check form template now.