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Daily Depression & Self-Harm Survey

  • Please rate the severity of your mental health symptoms today:

  • 1=Minimal 5=Moderate 10=Severe
  • 1=Minimal 5=Moderate 10=Severe
  • 1=Minimal 5=Moderate 10=Severe
  • 1=Minimal 5=Moderate 10=Severe
  • Please tell us about any thoughts of self-harm you may be experiencing:

  • Please see a staff member immediately, so we can ensure you're getting the support you need!

  • Thank you for completing this survey. You're done and can click "Submit"

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  • 393 Dunlap St N, Ste 300  Saint Paul, MN 55104
  • 612.289.5656 
  • info@mncarepartner.com
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  • About Us
    • Contact
      • Staff
      • Staff Links
    • Katy’s Story
    • Our Staff
  • Programs & Services
    • Zoom Teletherapy Info & Links
    • Therapy
    • Roots Recovery
      • Roots Recovery Home
      • Roots Client Forms
    • ARMHS Services
    • CTSS Services
    • Parent Community Support Program
    • Digital Navigation Services
  • Referrals/Intake
    • Electronic Forms Library
    • Make a Referral to Mental Health Services
    • Make a Referral to Roots Recovery
    • Mental Health Intake Forms
    • Internal Referrals
  • Trainings
    • Upcoming Trainings
    • Virtual Trainings
    • Your Training Account
    • Login to Training Portal
  • Careers