Rate Your Satisfaction In Life
Name *
Date *
MM
/
DD
/
YYYY
Rate your overall satisfaction with your life.
Very Unsatisfied
Very Satisfied
Clear selection
Rate how much fun you are having in life?
Very Little
A lot
Clear selection
Rate how happy you are in your current career.
Very Unhappy
Very Happy
Clear selection
Rate how overwhelmed, busy or cluttered you currently feel.
Not At All
Very Much
Clear selection
I like myself.
Not At All
Very Much
Clear selection
What is your favorite thing in your life at the moment? (Something you like the most)
What could be improved in your life at the moment? (Something you like the least)
I am looking:
Clear selection
I am ready to take action and make meaningful changes in my life
Clear selection
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