Form: Three-Item Loneliness Scale

1 – Hardly ever
2 – Some of the time
3 – Often
¹
1
2
3
1
How often do you feel that you lack companionship?
2
How often do you feel left out?
3
How often do you feel isolated from others?

The presented answer sheet is not an original form and is not intended for printing or use as a handout.

The answer numbers are used only to label response columns. They are NOT scores and should not be used for calculating results.