Holistic Health Assessment - Kick Off
The assessment aims to:

Provide a method for assessing and reporting participant progress that is simple and easy to understand - for participants and program leads.

Be based on high expectations and challenge for all and to provide opportunities for all participants to experience success.

Be focused on supporting participants in developing the knowledge, understanding and skills needed for success.

Supports program leads and encourages a ‘growth mindset’ by providing participants with high quality next-steps feedback focused on specific objectives
Sign in to Google to save your progress. Learn more
Email *
First and Last Name *
The Assessment Tool Scale will be a 5 point Likert Scale, ranging from:

Capable and Consistent - 4
Capable, Working toward Consistency - 3
Learning, Making Meaningful Progress - 2
Trying, Need Additional Support, Information or Time - 1
Resistant/Unwilling to Try/Not Ready to Change - 0
Has a holistic view of the body, mind, and spirit, understands how they are all integrated and interconnected *
Resistant /Unwilling to Try/Not Ready to Change
Capable and Consistent
Has the skills to help soothe the body's stress response *
Resistant /Unwilling to Try/Not Ready to Change
Capable and Consistent
Knows and understands the basic tenets of healthy nutrition for adults and children *
Resistant /Unwilling to Try/Not Ready to Change
Capable and Consistent
Practices self-compassion and has patience with pace of progress *
Resistant /Unwilling to Try/Not Ready to Change
Capable and Consistent
Incorporates movement into their daily routine *
Resistant /Unwilling to Try/Not Ready to Change
Capable and Consistent
Prioritizes hydration on a daily basis *
Resistant /Unwilling to Try/Not Ready to Change
Capable and Consistent
Knows, understands, and prioritizes good sleep hygiene for restful sleep *
Resistant /Unwilling to Try/Not Ready to Change
Capable and Consistent
Has a loving and respectful relationship with body *
Resistant /Unwilling to Try/Not Ready to Change
Capable and Consistent
Prioritizes self-care on a daily basis *
Resistant /Unwilling to Try/Not Ready to Change
Capable and Consistent
Creates healthy, whole food based meals for self and children on a regular basis *
Resistant /Unwilling to Try/Not Ready to Change
Capable and Consistent
Please feel free to share any additional thoughts or information:
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Stepping Stones Network. Report Abuse