Self_Assessment

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Name

First

Last

Health Question 1 – I wake up feeling well‑rested and energetic.

Selected Value: 3

1. Strongly Disagree 2. Disagree 3. Neutral 4. Agree 5. Strongly Agree

Health Question 2 – I engage in physical activity that raises my heart rate at least three times a week.

Selected Value: 3

1. Strongly Disagree 2. Disagree 3. Neutral 4. Agree 5. Strongly Agree

Health Question 3 – I feel confident managing my current health conditions (medication, nutrition, medical appointments).

Selected Value: 3

1. Strongly Disagree 2. Disagree 3. Neutral 4. Agree 5. Strongly Agree

Question ways experience

Happiness Question 1 – I experience joy or contentment on most days.

Selected Value: 3

1. Strongly Disagree 2. Disagree 3. Neutral 4. Agree 5. Strongly Agree

Happiness Question 2 – I feel socially connected and supported by friends, family, or community groups.

Selected Value: 3

1. Strongly Disagree 2. Disagree 3. Neutral 4. Agree 5. Strongly Agree

Happiness Question 3 – I handle everyday stress in ways that leave me calm and optimistic.

Selected Value: 3

1. Strongly Disagree 2. Disagree 3. Neutral 4. Agree 5. Strongly Agree

Purpose Question 1 – I have clear goals or projects that excite me for the months ahead.

Selected Value: 3

1. Strongly Disagree 2. Disagree 3. Neutral 4. Agree 5. Strongly Agree

Purpose Question 2 – I believe my skills or experience benefit others (family, community, workplace, or volunteering).

Selected Value: 3

1. Strongly Disagree 2. Disagree 3. Neutral 4. Agree 5. Strongly Agree

Purpose Question 3 – I frequently learn or explore new ideas that expand my sense of meaning.

Selected Value: 3

1. Strongly Disagree 2. Disagree 3. Neutral 4. Agree 5. Strongly Agree