Penny Brohn UK

Help change life with cancer. For good

Measure Yourself Concerns and Wellbeing (MYCaW) First Form (Counselling)

Meaningful Measures operates the licence for MYCaW and collects anonymised and non-identifiable data from all users around the world to create a database of anonymised concerns/symptoms/activities. This data collection helps organisations understand people’ needs. Your MYCaW data will be fully anonymised and sent securely ONLY to Meaningful Measures, for more information see their website: If you have any questions or concerns please email


PBUK MYCaW 1 - Counselling
AccessPlanIT ID

Please tick the relevant boxes below so we can understand more about the data collection:

I am a: (please select) *
This was completed: (please tick) *

Please write down one or two concerns or problems which you would most like us to help you with.

Please rate to show how severe each concern or problem is now:
This should be YOUR opinion, no-one else's!

Concern or problem 1
(0 = Not bothering me at all and 6 = Bothers me greatly) *
Concern or problem 2
(0 = Not bothering me at all and 6 = Bothers me greatly)

How would you rate your general feeling of wellbeing now? (How do you feel in yourself?)

(0 = As good as it could be and 6 = As bad as it could be) *

Measure Yourself Concerns and Wellbeing 2020 © Meaningful Measures Ltd

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