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  5. Personal Wellness Inventory Survey

Personal Wellness Inventory Survey

Sonyei Hijirida
0%
Exit Survey
 
 
Personal Wellness goes well beyond physical wellness. Wellness begins by assessing our current abilities, accomplishments, limitations, and goals. When we increase our awareness, we ignite the process in actively make decisions to achieving a balanced lifestyle.

This Personal Wellness Inventory survey is designed to identify key areas in which we feel we have achieved success and which areas we could use some help to improve.

Scale:    1= Completely disagree    2=Somewhat disagree    3=Neutral    4=Somewhat agree    5=Completely agree
 
 
 
PHYSICAL
Completely disagree Somewhat disagree Neutral Somewhat agree Completely agree
I eat healthy meals at least three times per week
I exercise regularly (20-30 minutes 3 times per week)
I feel energized most days
I sleep at least 7 to 8 hours on most nights
 
 
FINANCIAL
Completely disagree Somewhat disagree Neutral Somewhat agree Completely agree
I eat out more than three times per week
I am able to put away at least 10% of my earnings into savings
I shop (i.e., mall, store, etc) for items (i.e., clothes, bags, shoes) more than once per week
I put money aside each paycheck for retirement
 
 
SOCIAL
Completely disagree Somewhat disagree Neutral Somewhat agree Completely agree
I am able to effectively communicate with others
I am able to call my network (family, friends) when I have an issue or problem
I establish friendships easily
I have social gatherings with friends and/or family at least two times per year (aside from the holidays)
 
 
INTELLECTUAL
Completely disagree Somewhat disagree Neutral Somewhat agree Completely agree
I read personal and/or professional development literature at least 2-3 times per week
I set specific goals and have action plans in both my personal and professional life
I prepare my day by prioritizing the night before
I am comfortable with growth or changes (i.e., career, family, friends, etc)
 
 
SPIRITUAL
Completely disagree Somewhat disagree Neutral Somewhat agree Completely agree
I meditate or set aside at least 15 minutes of quiet time to relfect
I have set values that guide my decisions and actions
I am involved in a group or my community (i.e., religious, organizations, etc)
I feel a strong sense of purpose for my life
 
 
 
Have you seen a Life, Wellness, and/or Health Coach before?
   
 
SCORING

Add each column and add the columns together
- Between 90-100: You are very healthy in all aspects of your life and life a balanced lifestyle
- Between 80-89: You are well in some areas, but could use improvement in some of the other areas.
- 79 and under: You tend to have unhealthy habits and lifestyle. Learn ways in which working with a coach would be beneficial to improve your well-being and lifestyle.
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