Life Self-Evaluation
This form helps you reflect on the current state of the main areas of your life and what you would like to improve. It takes 5 to 10 minutes to fill out.

You email address is used to send you a copy of your responses, so you can compare with your future self.

Based on your answer to the question "Would you like to have help to be the best you can be?" your email address might also be used to contact you to talk further.

More information on https://kaue.me/
Email address *
How do you rate the following areas of your life?
Terrible
Bad
Good
Great
Health (sleep, nutrition, exercise, etc.)
Wealth (carreer, saving, investing, etc.)
Love (partner, friends, family, etc.)
Meaning (awareness, fun, good, etc.)
Other
Clear selection
How do you rate the following areas of your Health?
Terrible
Bad
Good
Great
Sleep (quantity, time you wake up)
Nutrition (what you eat and drink)
Exercise (strength, cardio)
Other
Clear selection
How do you rate the following areas of your Wealth?
Terrible
Bad
Good
Great
Career (growing, time management)
Saving (frugal, debts, taxes)
Investing (making money work for you, financial independence)
Other
Clear selection
How do you rate the following areas of your Love?
Terrible
Bad
Good
Great
Partner
Friends
Family
Other
Clear selection
How do you rate the following areas of your Meaning?
Terrible
Bad
Good
Great
Awareness (fewer mistakes, honesty, gratitude)
Fun (hobbies)
Good (moral, purpose)
Other
Clear selection
What is your biggest problem? What area would you like to improve first?
Would you like to have help to be the best you can be? *
Do you have questions, comments or feedback?
A copy of your responses will be emailed to the address you provided.
Submit
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