--- title: CPS Worker Wellness Check & Secondary Trauma Screening Form | Paperform description: Confidential wellness check form for child protective services workers to assess secondary trauma, case stress, court anxiety, and clinical supervision needs. Track and support CPS worker mental health. url: "https://paperform.co/templates/cps-worker-wellness-check-secondary-trauma-screening" type: static generatedAt: "2026-04-04T00:43:38.969Z" --- [← Back to free form templates](/templates/) ![CPS Worker Wellness Check & Secondary Trauma Screening](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/cps-worker-wellness-check-secondary-trauma-screening.png) [Preview](https://_preview.paperform.co/ai-template/cps-worker-wellness-check-secondary-trauma-screening) [Use this template for free](/create?ai-template=cps-worker-wellness-check-secondary-trauma-screening) [Emergency & Crisis Forms](/templates/category/emergency-crisis/)[Human Resources Forms](/templates/category/hr/)[Healthcare & Medical Forms](/templates/category/healthcare/) [Healthcare](/templates/industry/healthcare/)[Nonprofit](/templates/industry/nonprofit/)[Public Administration](/templates/industry/public-admin/) [HR Manager](/templates/role/hr-manager/)[Manager](/templates/role/manager/)[Counselor](/templates/role/counselor/)[Social Worker](/templates/role/social-worker/)[Nonprofit Director](/templates/role/nonprofit-director/) About this free form template Child protective services work is one of the most emotionally demanding professions, with workers regularly exposed to traumatic situations involving children and families in crisis. This **CPS Worker Wellness Check & Secondary Trauma Screening** form provides a structured, confidential way for agencies to monitor worker wellbeing, identify burnout risk factors, and connect staff with the clinical supervision and support they need. The form addresses the unique stressors CPS workers face—from managing complex caseloads and navigating court testimony to processing vicarious trauma from repeated exposure to abuse and neglect cases. By regularly checking in on emotional wellbeing, supervisors can intervene early, reduce turnover, and ensure workers have the resources to continue providing quality care to vulnerable children and families. This template is ideal for **social services agencies, child welfare organizations, nonprofit family services providers, and government child protective services departments** looking to prioritize staff mental health. The form can be deployed monthly or quarterly as part of a broader worker wellness program, or used following particularly difficult cases or court appearances. **Key features include:** - Secondary trauma symptom screening with validated indicators - Case complexity and workload stress assessment - Court appearance anxiety and legal process support needs - Clinical supervision quality and frequency evaluation - Self-care practice tracking and resource identification - Confidential supervisor follow-up requests With Paperform's conditional logic, the form can automatically route high-risk responses to supervisors for immediate follow-up, while general wellness data can be aggregated for trend analysis. For agencies managing multiple teams or locations, responses can flow into **Stepper** workflows that assign check-ins to the appropriate clinical supervisors, schedule debriefing sessions, or trigger resource emails based on specific needs identified. Results can integrate directly with case management systems, HR platforms, or analytics tools to track workforce wellness trends over time and inform organizational support strategies. By making wellness checks as routine as case documentation, agencies create a culture where asking for help is normalized and secondary trauma is recognized as an occupational reality rather than a personal failure. This Paperform template empowers CPS workers to honestly assess their mental health while giving supervisors the data they need to provide targeted, timely support that keeps workers healthy, engaged, and effective in their critical work protecting children. Built for growing businesses, trusted by bigger ones. Trusted by 500K+ business owners and creators, and hundreds of millions of respondents. ![Capterra - 4.8 out of 5](/images/capterra-st.jpg) ![Trustpilot - 4.8 out of 5](/images/trustpilot-st.jpg) ![G2 - 4.8 out of 5](/images/g2-st.jpg) [Try Paperform free now](/register) ## More templates like this [![Community Violence Intervention Worker Wellness Check](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/community-violence-intervention-worker-wellness-check.png) ### Community Violence Intervention Worker Wellness Check A comprehensive wellness check form for community violence intervention workers, designed to assess mental health, safety concerns, and vicarious trauma from street outreach and crisis mediation work.](/templates/community-violence-intervention-worker-wellness-check/) [![Refugee Trauma Therapist Wellness Check](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/refugee-trauma-therapist-wellness-check.png) ### Refugee Trauma Therapist Wellness Check A comprehensive wellness and support form designed for therapists working with refugee trauma survivors, addressing cultural competence strain, vicarious trauma, and the unique challenges of interpreter-mediated sessions.](/templates/refugee-trauma-therapist-wellness-check/) [![Mass Violence Response Counselor Wellness Check](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/mass-violence-response-counselor-wellness-check.png) ### Mass Violence Response Counselor Wellness Check A comprehensive wellness assessment for crisis counselors and mental health professionals responding to mass violence events, focusing on community trauma healing, media exposure, anniversary stress, and cumulative disaster fatigue.](/templates/mass-violence-response-counselor-wellness-check/) [![Child Protective Services Worker Wellness Check](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/child-protective-services-worker-wellness-check.png) ### Child Protective Services Worker Wellness Check A comprehensive wellness check form designed for CPS workers to assess secondary trauma, case complexity stress, court appearance anxiety, and identify clinical supervision needs for mental health support.](/templates/child-protective-services-worker-wellness-check/) [![Crisis Hotline Counselor Wellness Check](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/crisis-hotline-counselor-wellness-check.png) ### Crisis Hotline Counselor Wellness Check A comprehensive wellness assessment for crisis hotline counselors addressing call volume stress, vicarious trauma, boundary maintenance, and supervision needs to support mental health professionals in high-stress roles.](/templates/crisis-hotline-counselor-wellness-check/) [![Crisis Intervention Mobile Team Dispatcher Wellness Check Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/crisis-intervention-mobile-team-dispatcher-wellness-check-form.png) ### Crisis Intervention Mobile Team Dispatcher Wellness Check Form A comprehensive wellness check form for crisis intervention dispatchers to monitor stress levels, field safety concerns, resource coordination challenges, and shift fatigue to ensure team wellbeing and operational effectiveness.](/templates/crisis-intervention-mobile-team-dispatcher-wellness-check-form/) [![Forensic Interviewer Trainer Wellness Check Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/forensic-interviewer-trainer-wellness-check-form.png) ### Forensic Interviewer Trainer Wellness Check Form A comprehensive wellness check form designed for forensic interviewer trainers to assess stress levels, workload management, and support needs related to teaching, quality assurance, mock interviews, and field consultations.](/templates/forensic-interviewer-trainer-wellness-check-form/) [![Military Family Wellness Check During Deployment](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/military-family-wellness-check-during-deployment.png) ### Military Family Wellness Check During Deployment A comprehensive wellness assessment for military families during deployment, evaluating stress levels, support systems, financial concerns, and connecting families with base resources and support services.](/templates/military-family-wellness-check-during-deployment/) [![Crisis Pregnancy Center Counselor Wellness Check](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/crisis-pregnancy-center-counselor-wellness-check.png) ### Crisis Pregnancy Center Counselor Wellness Check A compassionate wellness check form for crisis pregnancy center counselors to assess emotional wellbeing, process client-related stress, and request peer supervision support.](/templates/crisis-pregnancy-center-counselor-wellness-check/) [![Domestic Violence Shelter Resident Wellness Check](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/domestic-violence-shelter-resident-wellness-check.png) ### Domestic Violence Shelter Resident Wellness Check A compassionate wellness check form for domestic violence shelter residents to assess safety, wellbeing, trauma symptoms, children's needs, and connection to support services.](/templates/domestic-violence-shelter-resident-wellness-check/) [![Homeless Veteran Welfare Check & Outreach Report](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/homeless-veteran-welfare-check-outreach-report.png) ### Homeless Veteran Welfare Check & Outreach Report A comprehensive form for reporting missing chronically homeless veterans with service-connected disabilities to facilitate coordinated outreach efforts between street medicine teams, VA homeless coordinators, and community support services.](/templates/homeless-veteran-welfare-check-outreach-report/) [![Perinatal Loss Doula Wellness Check Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/perinatal-loss-doula-wellness-check-form.png) ### Perinatal Loss Doula Wellness Check Form A compassionate wellness check form for perinatal loss doulas providing stillbirth support, NICU vigil care, memory photography, and bereaved family follow-up services.](/templates/perinatal-loss-doula-wellness-check-form/)