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Evaluate Your Health

The following set of questions was developed by the staff of Elements to assist you in your quest for health. It will help you recognize those areas of life that challenge your sense of wellbeing. It will also give you a personal introduction to the Five Elements of Health.

Read through each statement carefully and then answer "true" or "false" as it applies to your life over the past six months. After completing the survey, you will be guided to information and resources designed to help you move forward towards your wellness goals.

Please note: Your responses are completely confidential and are not recorded in any way.
Physical Health
1. Addictions. I am comfortable with the amount of addictive substances I use (e.g. alcohol, cigarettes, prescription and non-prescription drugs).

True False       More Information

2. Body Image. I am comfortable with my weight and body appearance.

True False       More Information

3. Eating. I am satisfied with my eating habits, including my level of knowledge about the best nutrition for my body.

True False       More Information

4. Exercise. I am comfortable with the amount and kind of physical exercise I get.

True False       More Information

5. Health problems. I am satisfied with how I manage my health problems.

True False       More Information

6. Safety. I take proper precautions to reduce my risk of injury.

True False       More Information

7. Self-Care. I am satisfied with the knowledge I have of how treat common ailments for myself and for my family.

True False       More Information

8. Sexual Health. I am satisfied with my sexual health.

True False       More Information

Results  |  Physical  |  Financial  |  Spiritual  |  Self  |  Relationship  |  Top

Financial Health

1. Debt. I am comfortable with my level of debt.

True False       More Information

2. Family. I am comfortable with how money is discussed and spent in my immediate family.

True False       More Information

3. Financial Stress. I am comfortable with my stress level when it comes to finances.

True False       More Information

4. Investing. I am comfortable with my skill level in investing and planning for my retirement.

True False       More Information

5. Management. I am able to manage my money so that my nAsic needs are met.

True False       More Information

6. Prosperity. Regardless of my financial situation, I feel that I am a prosperous person.

True False       More Information

7. Savings. I am able to save sufficient money for future expenses.

True False       More Information

8. Values. I am comfortable with my values, beliefs, and feelings about money.

True False       More Information

Results  |  Physical  |  Financial  |  Spiritual  |  Self  |  Relationship  |  Top

Spiritual Health

1. Beliefs. I am clear about my values and beliefs.

True False       More Information

2. Charity. I am comfortable with my ability to invest my time and/or money in causes that are important to me.

True False       More Information

3. Commitment. I am comfortable with the amount of time I spend in some form of spiritual practice.

True False       More Information

4. Connection. I am satisfied with the connection I have with my spiritual self and/or community.

True False       More Information

5. Integrity. I am satisfied with my ability to act and speak in ways that reflect my values.

True False       More Information

6. Joy. I often experience joy and a sense of fulfillment in my life.

True False       More Information

7. Love. I am able to give and receive the love I need.

True False       More Information

8. Meaning. I feel that my life has meaning or a purpose.

True False       More Information

Results  |  Physical  |  Financial  |  Spiritual  |  Self  |  Relationship  |  Top

Self Health

1. Anger. I am comfortable with the amount of anger I feel and my ability to express it appropriately.

True False       More Information

2. Balance. I am comfortable with how I nAlance my work and family life.

True False       More Information

3. Creativity. I am able to use my creative talents in my daily life.

True False       More Information

4. Goals. I am comfortable with my ability to set goals and follow through on them.

True False       More Information

5. Self-efficacy. I have confidence in my ability to effectively manage difficult situations that occur in my life.

True False       More Information

6. Self-improvement. I am comfortable with the time and money I am able to invest in self-improvement activities.

True False       More Information

7. Self-worth. I am satisfied with my level of self-worth.

True False       More Information

8. Stress. I am comfortable with my abilities to handle the stress in my life.

True False       More Information

Results  |  Physical  |  Financial  |  Spiritual  |  Self  |  Relationship  |  Top

Relationship Health

1. Conflict Management. I am satisfied with my ability to handle conflicts.

True False       More Information

2. Diversity. I am comfortable in my interactions with others of a different race, culture, gender, and/or sexual orientation.

True False       More Information

3. Family Relations. I am comfortable with the relationship I have with my family members.

True False       More Information

4. Feelings. I am comfortable with how, when, and whom I share my feelings.

True False       More Information

5. Friendship. I am comfortable with my ability to make and keep friends.

True False       More Information

6. Parenting. I am satisfied with my knowledge of parenting and/or other care-giving roles.

True False       More Information

7. Team Building. I am satisfied with how I function in and contribute to my work team.

True False       More Information

8. Work Relations. I am comfortable with my relationships at work.

True False       More Information
Results  |  Physical  |  Financial  |  Spiritual  |  Self  |  Relationship  |  Top

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