Questionnaire SMI | Cygnet Schema Integrative Report

Schema Mode Inventory

SMI V1.1 (124 Items)

Instructions:

Listed below are statements that people might use to describe themselves. Please rate each item based on how often you believe or feel each statement in general.

Rating Scale:

1 = Never or Almost Never4 = Frequently2 = Rarely5 = Most of the Time3 = Occasionally6 = All of the Time

*All fields are required to proceed

Your Name *

Email Address *

Date of Birth (DD/MM/YYYY) *

Gender *

Occupational Status *

Which parts of your life are you particularly concerned about at the moment? (Select all that apply)

Psychologist's Name