1-Never, 2-Rarely, 3-Occassionally, 4-Frequently, 5-Very Frequently
Physical Wellness
1
2
3
4
5
I get adequate sleep and awake feeling refreshed.
I get at least 30 minutes of moderate physical activity each day.
I eat regular, nutritious meals that give me the energy I need to stay active and get through the day.
I choose to abstain from sex or I practice safe sex.
I
do not
use alcohol (or use in moderation),
do not
use tobacco and avoid street drugs.
Emotional Wellness
1
2
3
4
5
I am able to ask for/seek out help when I need it from friends, family or professionals.
I am able to recognize and manage the different stressors in my life.
I value self-awareness.
I express my feelings appropriately.
Others would describe me as emotionally stable.
Career/Financial Wellness
1
2
3
4
5
I have a solid balance between saving for the future and spending for the present.
What I am doing with work/school has purpose.
I have a balance between work/school and the other areas of my life.
I live within my means (Example: I have the money I need and don’t borrow from my friends or family).
I seek to attain my career/financial goals.
Spiritual Wellness
1
2
3
4
5
I feel an overall sense of peace and wellbeing in my life.
I understand my own values and beliefs, and respect the values, ethics and beliefs of others.
I believe principles/ethics/morals provide direction and meaning in my life.
I practice meditation, prayer, or another similar practice.
I am living my life with a purpose.
Social Wellness
1
2
3
4
5
I am able to maintain healthy relationships with my loved ones.
I feel a sense of belonging (not feeling isolated) to a group or a community.
I respect others and their cultural identities.
I am aware of and able to set and respect my own and others’ boundaries.
I am able to resolve conflicts in all areas of my life.
Intellectual Wellness
1
2
3
4
5
I have specific intellectual goals (e.g., learning a new skill, a specific major).
I pursue my interests or hobbies.
I commit time and energy to professional and self-development.
I am able to focus on and complete a task in a timely manner.
I am able to adapt to change and learn new things.