JEWEL QUESTIONNAIRE

Privacy

No data or names are stored on this website or anywhere else. All data will be deleted when you click "Clear form" or when you leave this website. You may click the "Submit" button up to two times.

Instructions

• Fill in your Client numeric ID (1 - 1000)
• Fill in your counselor's country of origin and email address
• Answer the first 3 required questions
• There are 8 Topics: select the ones that apply to you.
• Answer selected questions as follows
  • 0 - N/A (does not apply)
  • 1 - Sometimes
  • 2 - Often
  • 3 - Almost always
  • 4 - My most important issue (select just once)
• When all questions are answered:
  • Click "Submit"
  • Lastly, "Clear Form" or leave website