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How often do you take time for yourself?
 
Daily
 
5 times a week
 
4 times a week
 
Weekly
 
Never
 
 
 
How do you relax?
 
Meditation
 
Exercise
 
Hobby
 
Reading
 
Other
 
 
 
 
Do you find it hard to take time to relax?
 
Yes
 
No
 
Sometimes
 
Never
 
 
 
Are you comfortable being alone?
 
Yes
 
No
 
 
 
If you answered no, why not?
 
 
Other
 
 
 
 
Do you need to be with other people to enjoy activities?
 
Yes
 
No
 
Other
 
 
 
 
When you chose to participate in a group activity is it an activity you enjoy doing or something others in your group enjoy doing?
 
Something I enjoy
 
Something they enjoy
 
Both
 
 
 
Do you find it relaxing to include others in certain relaxation time, ex. group exercise like yoga, outings, vacations, movies?
 
Yes
 
No
 
Sometimes
 
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