Scale: 1 = Never 3 = Sometimes 5 = 50/50 7 = Mostly 10 = Always
(rate each question below from 1 – 10)
_____ I am aware of my body and take deep breathes to manage my stress.
_____ I put aside time to practice deep breathing exercises (the relaxation response, progressive relaxation, or meditation).
_____ I reach my water-drinking goal every day (enough water to make my “water” clear or light yellow).
_____ I substitute water for sugared and/or caffeinated beverages.
_____ I sleep at least 54 hours each week.
_____ I am consistent with the time of night that I go to sleep and/or the time of morning that I wake up.
_____ I monitor and manage the quantity of food I eat (like the Hand Signals of Health), especially when eating out!.
_____ I eat a rainbow of vegetables and fruits at the first part of my meals each day.
_____ I am a success in reducing saturated fat (e.g. whole milk, fried foods, processed foods and fatty meats), trans fats (processed foods), refined carbohydrates (made from white flour and sugar), and high fructose corn syrup (prepackaged food) – read the labels!!.
_____ I successfully add monounsaturated fats (nuts, avocado, + olive products) and deep water fish (or fish oil supplements) to my diet.
_____ I eat balanced meals and snacks (lean protein, healthy carbohydrates and fats).
_____ I am active and play for at least 150 minutes per week or over 10,000 steps/day.
_____ I incorporate resistance training (core training, callisthenic or weights) in my program
_____ I incorporate aerobic activity (running, swimming, biking, skating dancing, circuit training, active work or play) into my exercise program,
_____ I incorporate flexibility exercises (palate’s, yoga, stretching) into my exercise program.
_____ I spend time and openly communicate with friends who call me to be my best and encourage me.
_____ I give without expectation to the people with whom I come in contact.
_____ I forgive myself and others for things that don’t go well.
_____ I am experiencing freedom and peace in my life.
_____ I am grateful for all that I have been given in life.
_____ I am managing the things I control, encouraging those I influence, and trusting things will work out with the things I don’t control.
_____ TOTAL SCORE
Healer that you think you need to improve in first __________________________________________
What actions could you take to improve in that area: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________