Instructions: For each question, select the number that best reflects your current habits and mindset.

SPIRITUAL HEALTH

1. I regularly reflect on what I believe and why I believe it. *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

2. I feel connected to something greater than myself. *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

3. I make time to practice spiritual or reflective habits (e.g., prayer, meditation, nature walks). *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

Instructions: For each question, select the number that best reflects your current habits and mindset.

EMOTIONAL HEALTH

4. I can name what I'm feeling without blaming others. *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

5. I take time to process my emotions instead of suppressing or avoiding them *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

6. I can communicate my needs and boundaries clearly in relationships. *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

Instructions: For each question, select the number that best reflects your current habits and mindset.

MENTAL HEALTH

7. I’m aware of my inner dialogue and how it affects my choices. *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

8. I regularly challenge negative or limiting thoughts. *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

9. I can sit with discomfort without immediately needing to fix or escape it. *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

Instructions: For each question, select the number that best reflects your current habits and mindset.

PHYSICAL HEALTH

10. I pay attention to what my body is telling me (fatigue, tension, cravings, etc.). *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

11. I move my body regularly in ways that feel good and sustainable. *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

12. I make conscious choices about sleep, nutrition, and rest. *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

Instructions: For each question, select the number that best reflects your current habits and mindset.

FINANCIAL HEALTH

13. I know where my money is going each month. *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

14. I make financial decisions that align with my values and future goals. *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

15. I can talk about money without shame or anxiety. *

1 = Rarely

2 = Sometimes

3 = Often

4 = Always

First Name

Last Name

Email *

Phone *

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