The document asks a series of questions to assess mental health and experiences with abuse. It advises that if the respondent answers "YES" to many questions, they should seek help from a specialist immediately. However, if they mostly answer "NO", there is no need to worry. The document was created by an international group including individuals from Poland, Spain, and Germany.

2. 1 .
A re the any pe ns in yo r fam that hav o
re rso u ily e r
had e o nal pro m
mtio ble s?
YES NO

3. 2.
We yo mntally abu d?
re u e se
YES NO

4. 3
.
We yo physically abu d?
re u se
YES NO

5. 4.
D o im rtant things in yo r life raise the le e
po u vl
o yo r e o ns?
f u mtio
YES NO

6. 5
.
A re the any o ns in w yo act u r
re ccasio hich u nde
the influ nce o stro e o ns?
e f ng mtio
YES NO

7. 6.
D o yo pre r spe
u fe nding yo r tim in
u e
iso n?
latio
YES NO

8. 7.
We yo de e o fo ss w n
re u priv d f ndne he
yo wre a child?
u e
YES NO

9. 8.
We yo a bu
re u lly?
YES NO

10. 9
.
D id yo abu anim w n yo wre
u se als he u e
a child?
YES NO

11. 1.
0
I s the v w o blod u asant fo yo ?
ie f o nple r u
YES NO

12. 1.
1
H av yo e e abu d yo r bo
e u vr se u dy?
YES NO

13. 1.
2
D o yo u v le w n in tro ble m
u se io nce he u so e
sitatio
ns?
YES NO

14. 1.
3
D o yo like playing w fire
u ith ?
YES NO

15. A nswrs
e
I f yo answre msty „YES ” yo
u ed o u
sho ld se a spe
u e cialist im e ly. B u if
mdiate t
yo answre mstly „N O” yo do hav
u ed o u n’t e
to wrry.
o

16. B y gro p 1
u
A gnieszka B e dnarz ( Po land)
Ew K ijas ( Po
a land)
K aro B arglik ( Po
lina land)
Amanda A rv lo B e nco rt ( S pain)
e the u
Yara M aría Z amra ( S pain)
o
Elizabe S antana ( S pain)
th
M iriam ( Ge any)
rm