20 original everyday-habit statements · Five full guides free
Reflect on one everyday habit over the past 30 days. Answer 20 optional statements and read five full guides, without naming the habit or receiving a risk grade.
20 questions · about 5 minutes · no signup
Current-page memory only: no saved draft or result, choice uploads, analytics or personal-result sharing. Reloading, changing language or leaving clears answers.
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Look back over the past 30 days with one common, nonurgent everyday habit in mind. This original preview organizes five sets of responses rather than diagnosing addiction. You never need to enter the habit’s name.
This is FermatMind’s original twenty-statement habit preview, adapted from the complete local Mini program form. Its five groups each contain four statements with equal numeric weight. The Chinese prompts and original skip choice are retained; the English text is a working translation.
This form has not completed psychometric, clinical or fairness validation. It is not the published COHS or DHS habit scale, and their studies do not establish validity for these twenty statements. The five descriptive groups are not a validated causal model or five independently established psychological traits.
Keep the same common, nonurgent everyday habit in mind for all twenty statements and recall the past thirty days. The website never asks you to enter the habit’s name. Choose how each statement fits your experience rather than counting how often the behavior occurred.
This form is not for alcohol or drug use, prescription changes, gambling, self-harm, dangerous behavior, eating-disorder-related behavior, withdrawal management or an urgent safety problem. It supplies neither diagnosis nor clinical guidance. Real-world safety concerns take priority over completing a questionnaire.
Each part uses the numeric answers to its four statements. At least three numeric answers are required: add those values and divide by their count, then round the mean to four decimal places. The raw sum and numeric-answer count are displayed with the mean; skips are excluded. For 2, 4 and 5 plus one skip, the sum is 11 and the mean is 3.6667.
The option 3 means uncertain or dependent on the situation and still enters the calculation. A mean is a description of the answers, not frequency, a measure of habit strength, impairment or addiction probability. Decimal places express arithmetic; they do not establish psychological precision. There is no overall score, ranking, high/medium/low band or population percentile.
Every statement offers an explicit prefer-not-to-answer choice. To finish, each of the twenty statements must have a numeric choice or that skip choice; an untouched blank is different. Skips are valid and never guessed, scored as zero or replaced with 3. Fewer than three numeric answers withholds the part’s personal interpretation and numeric values.
Choosing skips for all twenty statements can finish the form. If all five parts are insufficient, the personal result shows scope, privacy and support boundaries rather than inferred patterns or a demand to try again. The five complete public reference guides remain available separately and do not require any personal responses.
A larger mean does not establish addiction or a need to stop an activity; a smaller mean cannot rule out a real concern. The records do not assess willpower, moral character, motivation or suitability for a job, school or relationship. Do not use them for medical, judicial or security screening. Several statements can refer to one episode, so the five means are not independent confirmations of severity.
Do not use the form to change prescriptions or attempt dangerous withdrawal. Persistent effects on sleep, tasks, relationships, finances or safety can be discussed with qualified professional services regardless of questionnaire values. Optional everyday observation ideas are not a treatment plan and promise no improvement. For an urgent safety problem, prioritize local emergency services or a trusted person.
The form requests no habit name or free text and uses only current-page memory. It saves no draft or result, transmits no choices and supplies no personal-result sharing or copying control. Reloading, changing language, leaving or restoring a page from browser history clears the response state.
Analytics are disabled for this form and its public reference guides, including consented page-arrival events. You can read the guides without taking the form, leave without explaining and repeat only if you want to. No saved record is compared across visits, and a later different response set does not by itself establish improvement or deterioration.
Five complete guides cover cues and urges, automatic starts, displaced plans, continuing after inconvenience and everyday effects. Read them before answering. Each four-item part needs at least three numeric responses for its separate sum and mean, without an overall total or ranking. Insufficient information yields no personal factor interpretation; all skips can finish the form. Public guides contain no personal answers or values.
A full reading of four statements about cues and wanting to begin one everyday habit, with examples, descriptive arithmetic and room to skip.
A full guide to four statements about beginning before noticing, following another action and drifting away from a task, with descriptive calculations and concrete contrasts.
Read four statements about postponed tasks, extra time, reduced rest and rearranged plans without turning them into a reliability or risk grade.
A full guide to four statements about continuing, intended limits and adjustments that did not become consistent, with examples and descriptive calculation boundaries.
A full reading of four statements about rest, tasks, contact and changes to usual plans, keeping descriptive responses separate from severity and clinical conclusions.
No. It organizes self-reported answers about one nonurgent everyday habit. There is no overall score, risk grade or diagnostic cutoff, and the original form has not completed clinical validation.
No. Keep it in mind while answering. There is no habit-name field or free-text response, and the website does not ask you to upload private observation notes.
At least three of four statements need numeric answers. Their sum is divided by their numeric count and rounded to four decimal places. Skips are excluded and the five means are not added or ranked.
No. The source option 3 means uncertain or dependent on the situation and is numeric. Prefer not to answer is an explicit skip that does not enter the sum or mean.
Yes. Process each statement with the skip choice to finish. If all parts have fewer than three numeric answers, no personal factor interpretation appears and you are not asked to answer again.
No. All five general reference guides are free and open separately. They explain the statements and their limits without supplying anyone with an inferred personal result.
No. This form uses current-page memory, clears responses on reload, language change or leaving, disables analytics and has no personal-result sharing. It cannot restore a previous record.
No. These twenty Chinese statements are FermatMind originals with a working English translation. COHS and DHS are different research scales; their evidence does not validate this form.
Website content edition 1.0.0 ·
Source question / scoring / report versions: habit_mini_original_0.1.0_fm_en_working_v1 / five4_min3_skip_sum_mean4dp_no_ranking_v1 / habit_mini_five_full6_v1