How often do you engage
in physical activities per week?:

How many hours do you
sleep on average per night?

Rate your stress levels on a scale 1 to 5

How many hours per week
do you spend on self care
practices?

How many hours per week do you spend
engaging in creative activities?

How often do you engage in Community
Service Involvement per week?

Rate your stress levels when facing a
change on a scale 1 to 5

How many hours per day do you spend
with your family/friends

Rate on a scale 1 to 5 your issues with the
following: falling asleep, staying asleep,
waking up too early and not being able to
go back to sleep, getting sleep but not
feeling refreshed by it

Rate on a scale 1 to 5 how clear is your
“why” in life