Touch Experience Questionnaire

Simply complete the questionnaire. If you don't want to answer some items just leave them blank, but let us have your comments at the end. Don't think too hard about the statements and go with your first feelings. Work quite quickly. Completion of this questionnaire will take approximately 20 minutes.

General Questions

Please fill in the spaces provided. For multiple-choice questions, please indicate the response most applicable to you.

1. Are you	Male Female
2. How old are you?	Years
3. What is your marital status?	Single In a relationship Married Cohabitating Divorced Separated Widowed
4. How many children do you have? How old are your children? How many of your children live with you?
5. Do you have any pets? If yes, please state	Yes No
6. What is your current employment status?	Working full time Working part-time Student Retired Housewife/Househusband Unemployed but seeking work Unemployed due to health problem
7. Have you ever had professional help for emotional or psychiatric problems?	Yes No
8. Have you sought or needed help for depression in the last year?	Yes No
9. Have you been feeling persistently depressed or in a low mood for the past two weeks?	Yes No
10. Have you ever had a period of a month, excluding bereavement, during which time you felt very depressed, so much so that it interfered with your work and interests?	Yes No
11. Are you currently being treated for depression?	Yes No
12. In general, would you say your health is...	Excellent Good Fair Poor Very poor