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ANSWER ALL
QUESTIONS TO THE BEST OF YOUR ABILITY |
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CHECK THE BOX
THAT BEST MATCHES YOU HOW YOU FEEL |
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Strongly Agree |
Agree |
Disagree |
Strongly Disagree |
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I feel
that I am a person of worth, on an equal plane with others.
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All in all, I
am inclined to feel that I am a failure. |
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I am able to
do things as well as most other people. |
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I feel I do
not have much to be proud of. |
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I take
a positive attitude toward myself. |
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| I wish
I could have more respect for myself. |
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| I
certainly feel useless at times. |
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| I feel
I have a number of good qualities. |
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| At
times I think I am no good at all. |
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| On the
whole I am satisfied with myself. |
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| I am an
outgoing person. |
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| I lack
companionship. |
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| I feel
left out. |
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| There
is no one I can turn to. |
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| I feel
isolated from others. |
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| I can
find companionships when I want it. |
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| People
may bee around me but they are not with me. |
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| I am
unhappy being so withdrawn. |
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| I worry
about finding dating partners of the same sex. |
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| Its no
problem telling my family I am gay, lesbian or bi. |
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| I have
trouble in dating relationships. |
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| I worry
about telling straight friends about my being g/l/b. |
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| I
struggle with religious beliefs and being g/l/b. |
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| Its
easy to tell people at school that I am g/l/b. |
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| I worry
about getting HIV. |
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