About your situation Which of these is closest to your situation? Please choose Anxiety Depression Anxiety and depression ADHD Bipolar disorder Postnatal or perinatal depression or anxiety PTSD OCD Something else I'd rather explain on the call
When were you first diagnosed, or when did this begin? Please choose Within the last year 1 to 5 years ago 5 to 10 years ago More than 10 years ago
How have things been for you over the last 12 months? Please choose Steady and well Mostly good with some harder patches Quite difficult
Are you currently taking medication for your mental health? Please choose Yes, settled on it Yes, started or changed recently No I'd rather say on the call
In the last 2 years, have you needed time off work because of your mental health? Please choose No Yes, a short time Yes, a month or more I'm not working at the moment
Have you ever been admitted to hospital in relation to your mental health? Please choose No Yes, more than 2 years ago Yes, within the last 2 years
Have you ever had thoughts of self-harm or suicide that you needed support with? Please choose No In the past, more than 2 years ago Within the last 2 years I'd rather talk about this on the call
Do you have any other medical conditions? Please choose Yes No
Do you smoke or vape? Please choose Yes No Quit in the last 12 months
What's prompted you to look into this now? Please choose Buying a home New baby or growing family Reviewing existing cover Been declined before Just finally getting round to it Something else
Continue And if things are heavy right now, cover can wait. Support is available any time from Samaritans on 116 123 .