Lifestyle Balance Exercise - 30 Day Action Plan Rating
This survey will ask you to rate five areas of wellbeing, your answers will be displayed when you are done. The objective of this exercise is not to be compared against a scale or receive a score.  The results are not intended to cause alarm but to indicate risk areas within your life where you can adjust your behaviour to restore some balance and improve the underperforming areas of wellbeing.  Diagnose - Develop - Thrive.

Questions marked with a * are required
Knowledge is power…only if you apply it or take action
This is about lifestyle balance; as a starting point, think about the different areas of your life and give them a score.
Rate on a scale: Zero being poor, 10 being Excellent
01 2 3 4 5 6 7 8 9 10
Physical Wellbeing
I keep my body moving: I feed, water and exercise it well
Mental Wellbeing
I keep my mind alive: I stimulate my brain to think and problem solve
Emotional Wellbeing
I keep a positive mood: I recognise and acknowledge how I feel and can process my emotions
Social Wellbeing
I keep a support network: I have a variety of friends and family that I can rely on and who can rely on me
Spiritual Wellbeing
I keep mindful of a bigger picture: not necessarily religious but connected to something other than just me
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