/Bright Light

5. Has the Covid-19 virus made this worry worse or better or not changed it *

1 worse

2

3 no change

4

5 better

6. Has the virus caused any new problems for you and your family? *

Yes

No

8. My family are good at talking and listening. *

1 I feel happy

2

3

4

5 I feel sad

9. My family care about each other. *

1 I feel happy

2

3

4

5 I feel sad

10. My family are good at dealing with problems *

1 I feel happy

2

3

4

5 I feel sad

11. Name of parent or guardian *

Please sign here as parent or guardian by typing your name, contact email address and completing the date signed.

First Name

Last Name

12. Date signed *

MM

DD

YYYY