Physical Wellness

Attitude
I am motivated to take care of my physical health.
Rate (0-10): _____________

I try to live in a way that maximizes my life rather than reacting to whatever symptoms I experience.
Rate (0-10): _____________

When I am experiencing symptoms, I use medications as a last resort.
Rate (0-10): _____________

Exercise
I make sure my body gets at least 10 minutes of exercise every day.
Rate (0-10): _____________

I am motivated to exercise because I understand how it benefits me now, as well as how it will benefit me in the future.
Rate (0-10): _____________

Nutrition
I know what nutrients my body needs to function at its best, and I make sure my body receives enough of them every day.
Rate (0-10): _____________

I eat regular, well proportioned meals every day, and I avoid snacking in between my scheduled meals.
Rate (0-10): _____________

Relaxation
I make sure I get enough rest every day.
Rate (0-10): _____________

I know how my body feels when I am getting stressed, and I know how to reduce my stress.
Rate (0-10): _____________

Posture
I try to ensure my posture is correct no matter what I am doing.
Rate (0-10): _____________

I recognize the unique physical demands of my occupation, and I take steps to counteract them.
Rate (0-10): _____________

I understand the importance of good posture in maintaining a healthy spine and nervous system.
Rate (0-10): _____________


Emotional Wellness

Attitudes
I am often looking at life from a ‘the glass is half-full’ perspective. People call me more of an optimist as I think about today or the future.
Rate (0-10): _____________

I feel confident about who I am and my skills and abilities. Although I know I’m not perfect, I believe I have a lot to offer others.
Rate (0-10): _____________

I believe I have a purpose for my life; I make decisions according to my values.
Rate (0-10): _____________

Emotions
I experience more positive emotions like happiness, joy, peace, confidence and contentment instead of stress, fear, anxiety, depression, anger or doubt.
Rate (0-10): _____________

Behaviours
I know what I want in life and I’m confident about going after my goals. Although I seek guidance from others, ultimately, I feel confident about my own decision-making.
Rate (0-10): _____________

I’m confident when I express my thoughts and feelings to others. In times of conflict, I am respectful towards others yet assertive with my thoughts.
Rate (0-10): _____________

Relationships
I feel secure and confident about my family relationships (spouse, children, family) in my life. I feel respected, loved and cared for.
Rate (0-10): _____________

I feel enriched by a community of friends who care and support me.
Rate (0-10): _____________

Scheduling
I am excellent at how I manage my time. I’m able to focus, accurately estimate how long tasks take and schedule ‘down-time’. I’m careful not to over-commit or over-schedule myself.
Rate (0-10): _____________

Finance
I’m careful about how I spend my money. I budget carefully, stick to my budget, invest and buy wisely and know where most of my money goes.
Rate (0-10): _____________


Environmental Wellness

Organization
My home and personal area is organized, tidy and clutter-free.
Rate (0-10): _____________

All of my belongings and my stuff “has a home”. I try to purge unused items regularly to avoid clutter and a build-up of ‘stuff’.
Rate (0-10): _____________

People are wired and function very differently. Your natural brain preference is either left (systems + harmony) or right (creative + chaotic). My organizational system is 100% a reflection of my natural preference and therefore I function at an optimal level.
Rate (0-10): _____________

Colour / Lighting
The colours I use are calming and reflect who I am and what I love. I feel relaxed, peaceful and in control in my environment.
Rate (0-10): _____________

The lighting in my space is strategic, ambient, functional yet calming.
Rate (0-10): _____________

Inspiration
My surroundings (home, bedroom, office, car, workshop area) are filled with pictures, positive memories and objects that inspire me.
Rate (0-10): _____________

Functionality
My space and furniture is comfortable and user-friendly. I am able to use my space and environment efficiently and effectively.
Rate (0-10): _____________

I can find anything I need in my space within 3 minutes.
Rate (0-10): _____________

The layout of my space is optimal. My furniture and layout allows an ease of traffic flow. I feel like I have lots of space.
Rate (0-10): _____________

Auditory / Noise
I try to fill my environment with music and sounds I love and that inspire me. I try to limit ‘noise’.
Rate (0-10): _____________


Time to add up your score.
What is your overall wellness?

Physical Score Total: ______________

Emotional Score Total: ______________

Environmental Score Total: ______________


What your score means:

Score 0-49
Oh boy – there are many areas that need work. Be kind to yourself and try to focus on 1 or 2 areas that need immediate attention. Remember, wellness is a journey. Personal coaching will be very helpful for you!

Score 50-69
While you’re strong in some areas, other areas could use some work. Try to focus on 1 area that concerns you. Personal coaching will help you fine tune some skills that need work.

Score 70-85
Overall, good job! You have several strengths and few areas that need attention. Try to focus on 1 or 2 of your lower scores. Personal coaching can equip you with more practical tools.

Score 86-100
Overall, great job! You have many strengths. Keep up the great work and remember: wellness is a journey, not a destination. Never stop learning!