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Please set up your confidential account to take a screening, review results, or get support.
If you are a parent/guardian and wish to complete a screening for more than one child, please set up a separate account for each child.
Each account must have a unique username.



The information you share in this screening will generally be kept confidential. Your responses and results are protected and will only be shared with your consent. However, the law requires disclosure in some situations even without your permission.

Confidentiality cannot be maintained when:
  • You share that your child may seriously harm her/himself or harm others.
  • You share that your child is being abused – physically, sexually, or emotionally.
  • You/your child are involved in a court case and a formal request is made for information about your screening.

Except for the situations described above, your responses to the screening questions will not be disclosed to others.

During your screening, if you share that your child is in danger of self-harm, harm to others, or is in an abusive situation, you will be contacted by a mental health professional from Well Family - typically within 24-hours. This crisis-response service is funded by

  • It is important for you to know that if you want your screening results removed from Heads Up Checkup database, you can submit a request to “opt-out.” You may do so in writing by mail to Wellify Teen, P.O. Box 351, Ross, CA 94957.  

  • Information disclosed pursuant to this Consent could be re-disclosed by the recipient and might no longer be protected by federal confidentiality law (HIPAA). However, California law prohibits the person receiving your health information from making further disclosure of it unless another Consent for such disclosure is obtained from you or unless such disclosure is specifically required or permitted by law.

  • See Terms and Conditions below for HIPAA Privacy Notice and security.
Clicking on the Submit Registration button below will immediately create and open your confidential account. Your username and password will be sent to the email address you provided above. You will be asked to reset your password and then you can complete a screening, view your results, or get support.