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Have you ever: 1) **Self-harmed? **2) Gotten into a real fight? 3) Been too depressed to move out of your bed? 4) Tried to commit suicide? 5) Had to lie to everyone about how you felt? 6) Watched an entire season of a TV show in one sitting? 7) Talked yourself out of serious trouble? 8) Accused someone of using you? 9) Shoplifted? 10) Gotten drunk/high? 11) Been to a concert where your favourite artist was playing? 12) Skipped doing homework to play a video game?
Right now, are you: 13) Suicidal? 14) Bored? 15) Avoiding someone? 16) Avoiding some task? 17) Depressed? 18) Crying? 19) Annoyed with a friend? 20) Worried and confused about something important to you?
Do you: 21) Get depressed easily? 22) Get jealous/envious easily? 23) Feel like listening to music can take your mind off things? 24) Worry about messing about your relationships a lot? 25) **Try hard in all your classes at school? **26) **Go out drinking? **27) Smoke cigarettes? 28) Smoke weed? 29) Do any hard drugs? 30) If you said yes to 28 but no to 29, why? 31) Believe in God/belong to a religion of your own free will? 32) Avoid people you care about because you feel you will only hurt them? 33) Agree that self-harm numbs emotional pain? 34) Believe people deserve second chances? 36) Think things will get better? 37) Feel afraid that you have done wrong and will eventually be punished? 38) Judge people who think differently to you?
Preference in boyfriend/girlfriend: 39) Long hair or short hair? 40) Nice smile or nice abs? 42) Shy or open? 43) Eyes or body? 44) Religious or non-religious? 45) Caring or non-restricting of you? 47) Piercings or no piercings? 48) Tattoos or no tattoos? 49) Quiet stay-at-home type or party type? 50) Has friends you get along with or has parents you get along with?