Holistic Wellness Assessment
Instructions: Answer each question honestly based on your current lifestyle and habits. Use the scoring guide at the end to assess your overall wellness.
1 / 29
Category: Physical
How often do you engage in physical activity?
2 / 29
How would you describe your current level of flexibility and mobility?
3 / 29
How well do you feel you understand how your body responds to exercise and what exercises best fuel your body?
4 / 29
How frequently do you experience pain that limits your ability to engage in life activities?
5 / 29
What is your level of satisfaction with your strength (to do the things you want/need to do)?
6 / 29
What is your level of satisfaction with your overall fitness?
7 / 29
Category: Nutrition
How would you rate your understanding of your body’s unique nutritional needs?
8 / 29
How would you rate the balance of your daily meals?
9 / 29
How often do you consume sugary or highly processed snacks?
10 / 29
How often do you experience abdominal pain/bloating, diarrhea, gas, heartburn or upset stomach after eating?
11 / 29
How many glasses of water do you typically drink in a day?
12 / 29
How many glasses of alcohol do you typically have in a week?
13 / 29
How many cups of coffee or caffeinated beverages do you have in a day?
14 / 29
Category: Sleep
How would you describe the quality of your sleep?
15 / 29
How many hours of sleep do you usually get each night?
16 / 29
How frequently do you typically wake up in the middle of the night?
17 / 29
Category: Social/Emotional
How often do you engage in social activities or connect with friends and family?
18 / 29
How often do you engage in something that you enjoy doing? (hobbies, self care, down time)
19 / 29
How often do you feel depressed or lonely?
20 / 29
How often do events from your past affect your mood or ability to engage in life how you’d like to?
21 / 29
How often do you feel proud of who you are and where you are in life?
22 / 29
How would you rate your support system for your emotional needs (people to talk to)?
23 / 29
How would you rate your coping skills to handle stress and/or adversity?
24 / 29
Category: External/Environmental
How would you rate your support system for logistical needs (sharing the load)?
25 / 29
How often do you feel very stressed or anxious about life/work requirements?
26 / 29
How often do you feel very stressed or anxious about money?
27 / 29
How satisfied are you in your relationship (with partner, spouse)
28 / 29
Category: Uncategorized
What is your first and last name?
29 / 29
What is your email address?
Your score is
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