Level III Student Evaluation Form

USA?

YesNo

Have you completed the Erika’s Lighthouse program?

Which of the following are signs and symptoms of depression (select all that apply)

Sadness, anger or moodinessChange in appetite or weightSleeping too much or too littleRestlessness or sluggishnessSpending more time with family and friendsTrouble making decisions or focusingThoughts of suicide or self-harmFeelings of worthlessness and guiltBeing more engaged and having more fun with your favorite activities

Which of the following are examples of who could be a Trusted Adult (select all that apply):

I would be comfortable talking with a friend if they told me about their depression.

I would be comfortable talking with a trusted adult about my mental health (select all that are true):

How has your ability to help someone with depression changed because of the Erika’s Lighthouse program?