Life Satisfaction & Life Balance
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Name *
How satisfied are you with your life currently? How would you rate each area of your life?
Place a number from 1 to 10 in the circle under to each item: a “1” score means “entirely unacceptable to me in its current state”, a “10” score means “I couldn’t be happier with this”. Enter “0” for any that do not apply
Personal Spiritual Life and Growth
Clear selection
Physical Health
Clear selection
Marriage/Romantic Relationship
Clear selection
Home Life (Family Cohesion – How the Family “Works”)
Clear selection
Personal Order (Organization, Efficiency, Simplicity)
Clear selection
Extended Family Relationships (Relatives, In-Laws)
Clear selection
Friends/Social Life
Clear selection
Fun and Recreation/Hobbies
Clear selection
Financial Stability
Clear selection
Physical Environment (Home, Cars, Neighborhood, etc.)
Clear selection
Career/Employment
Clear selection
Describe your ideal day. What would that day be like or look like?
Now describe what an ideal life would be like in the areas that you scored lowest in on the Balance Test.
What are you tolerating and what is draining your energy?
Home: What is draining your energy? What do you need to de-clutter this area?
Mental: What kind of negative thinking preoccupies your thoughts?
Emotional: What is robbing you of joy? What is zapping your energy?
Relational: What relationships are toxic to you and draining you of energy?
Spiritual: What is cluttering your walk with God? Lack of time? Anger or forgiveness issues?
Needs: What about your needs? What are three of your most pressing needs right now?
If you could make one change in one area of your life right now, what would it be?
What would be your first small step to achieve that change?
A copy of your responses will be emailed to the address you provided.
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