Well Being Assessment

Directions: Please rate from highly agree to highly disagree to the following questions. Choose only Two (2) categories you would like to focus on for your next coaching session.
  • 1. I feel intellectually stimulated in my social environments.
  • 2. I have personal development goals and engage in continuing education practices.
  • 3. I have a regular meditation practice or take brain “breaks” throughout the day.
  • 4. I have a healthy level of control over the direction of my thoughts and judgments.
  • 5. I am committed to personal awareness and growth.
  • 1. I engage in cardio exercise four or more times per week for at least 30 minutes.
  • 2. I drink enough water and eat a healthy, balanced diet.
  • 3. I get the needed amount of rest each night (7-9 hours for most adults).
  • 4. I am an active participant in my personal health and have all the knowledge to succeed.
  • 5. I have a healthy relationship with my body.
  • 1. My physical environments are clean and orderly.
  • 2. I breathe clean air and get plenty of sunlight daily.
  • 3. I engage in environmental sustainability practices.
  • 4. I feel pleased with the arrangements of my physical settings.
  • 5. My environment is arranged in a way that aligns with my energy and productivity objectives.
  • 1. I feel balanced in my role within my relationships.
  • 2. I feel confident in my ability to nurture my relationships.
  • 3. I feel a sense of community within my home and in other social environments.
  • 4. I am able to resolve interpersonal conflicts.
  • 5. I feel valued and connected in my social environments.
  • 1. My work and/or hobbies are founded on meaning and purpose.
  • 2. I have a healthy balance of work and personal life.
  • 3. I feel it is safe to express my true self in my work relationships, and I feel secure and safe in those relationships.
  • 4. I feel stimulated and challenged by my work and/or hobbies.
  • 5. I have the resources and connections needed to make progress in my occupational goals.
  • 1. I have an understanding of wants versus needs, and I prioritize spending in a responsible way.
  • 2. I pay my bills on time and balance my accounts regularly.
  • 3. I have specific financial goals of paying debts and/or saving weekly/monthly.
  • 4. I hold myself accountable for my adherence to my financial goals.
  • 5. I have a plan for long-term financial management and retirement savings.
  • 1. I am able to identify my emotions and determine their source.
  • 2. I am able to healthfully process my emotions, working through them without “bottling” them.
  • 3. I express myself honestly and calmly, and I respect and value the perspectives of others.
  • 4. I maintain a general sense of inner peace.
  • 5. I am rooted in ethical values and driven by the interests of the greater good.