UMatter Wellness Self-Assessment Use Request

The Wellness Self-Assessment is a tool created by Princeton University’s UMatter initiative. It is intended for individual level self-reflection and goal-setting. In its current form, it is not a validated tool and should not be used for research or diagnostic purposes. Permission for appropriate use is required.

To request using this tool with the above stipulations, please complete this form in its entirety and attach any additional information, as requested. If you have further questions, email

Please allow adequate time (~2 weeks) for the review of your proposal. Upon review, you will be contacted with a decision or request for clarification.

General information
Intended Use
Specify which questions and intended changes
Material Upload
Files must be less than 2 MB.
Allowed file types: jpg jpeg png pdf.