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College/Trade School Student Life Assessment
This assessment gives you a numerical understanding of your health and well-being in different aspects of your life. It is also one way to see if health & wellness coaching may be beneficial for you.
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* Indicates required question
Email
*
Your email
Your Name:
*
Your answer
Your Age
*
17 - 23
24+
Rating Scale
Please choose the number that you feel best describes each area of your life. The higher the number, the more satisfied you are in that area.
Rate Your Physical Health & Well-Being
*
Poor
1
2
3
4
5
6
7
8
9
10
Superb
Rate Your Mental/Emotional Health & Well-Being
*
Poor
1
2
3
4
5
6
7
8
9
10
Superb
Rate Your Spiritual Well-Being
*
Poor
1
2
3
4
5
6
7
8
9
10
Superb
Rate Your Quality of Daily Life
*
Poor
1
2
3
4
5
6
7
8
9
10
Superb
Rate Stress Levels in Your Life
*
Low
1
2
3
4
5
6
7
8
9
10
Extremely High
Rate Your Ability to Handle Stress Well
*
Poor
1
2
3
4
5
6
7
8
9
10
Superb
Rate Your Fatigue (past month or week)
*
No Fatigue
0
1
2
3
4
5
6
7
8
9
10
Extreme Fatigue
Rate Your Classes & Grades
1
2
3
4
5
6
7
8
9
10
Clear selection
Rate Your Extra Curricular Activities: Sports, Band, Theater, Music, Clubs...
*
1
2
3
4
5
6
7
8
9
10
Potential Career Opportunities
Poor
1
2
3
4
5
6
7
8
9
10
Superb
Clear selection
Rate Your Friendships
Unhealthy, Not Supportive - They Drag Me Down
1
2
3
4
5
6
7
8
9
10
Healthy, Supportive - They Help Me Be My Best
Clear selection
Rate Your Family Relationships
*
Unhealthy, Not Supportive
1
2
3
4
5
6
7
8
9
10
Healthy, Supportive
Rate Your Marriage, Boyfriend/Girlfriend, or Dating Relationship
Unhealthy, Not Supportive - I Feel He/She Drags Me Down
1
2
3
4
5
6
7
8
9
10
Healthy, Supportive - They Help Me Be My Best
Clear selection
Time You Spend Doing Fun or Enjoyable Activities. Do You Get Enough Time Doing These Activities?
Not Getting Any Time for Fun
1
2
3
4
5
6
7
8
9
10
Doing Great
Clear selection
Rate Your Living Situation (Dorm Room, Apartment, Parents' Home, Roommates...)
Poor
1
2
3
4
5
6
7
8
9
10
Superb
Clear selection
Rate Your Physical Environment/Where You Attend College/Trade School
*
Poor
1
2
3
4
5
6
7
8
9
10
Superb
Rate Your Finances
Poor
1
2
3
4
5
6
7
8
9
10
Superb
Clear selection
Rate Your Physical Environment/Where You Work
Poor
1
2
3
4
5
6
7
8
9
10
Superb
Clear selection
Rate Your Volunteer Work or Time You Take to Help Friends, Family & People in Your Community.
*
I Don't Volunteer or I Don't Enjoy It
1
2
3
4
5
6
7
8
9
10
Superb - I Enjoy It & It Enhances My Life
1
2
3
4
5
Clear selection
How important is it to you to improve your health & well-being?
*
Unimportant
0
1
2
3
4
5
6
7
8
9
10
Extremely Important
How important is it you to improve your quality of life?
*
Unimportant
0
1
2
3
4
5
6
7
8
9
10
Extremely Important
How in charge of your health do you feel?
*
Not At All
0
1
2
3
4
5
6
7
8
9
10
Very Much
Thank you for taking the time to complete this assessment! Please review your ratings and consider the following questions.
What areas of your life would you like to improve? How would it improve your life? What changes would bring greater meaning, purpose & joy into your life? What will your life look like and how will you feel in 5-10 years if you choose to improve this area(s) of your life? What will your life look like and how will you feel in 5-10 years if you choose not to improve this area(s) of your life?
*
Your answer
If this assessment has piqued your interest, please feel free to call, email, or schedule an appointment for a free consultation. 847-875-8070
alicia@struggles2triumphs.com
https://www.struggles2triumphs.com/
Your answer
A copy of your responses will be emailed to the address you provided.
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