Self Care Assessment

A self care assessment is the first step in creating a plan for self care, that can be part of a broader health and wellness plan. This assessment includes a review of the following domains of health and wellness: physical health, nutrition, mental health, intellectual health, emotional health, spiritual health, social health, relationships, cultural diversity, occupational health, financial literacy, academic health, and environmental health.

Please review the following questions and rate each statement on a 10 point scale, with how satisfied you are with your efforts on each area. 1 on the scale is completely dissatisfied and want to improve in this area, while a 10 on the scale is extremely satisfied and you need very little improvement in this area. After you have reviewed the questions, and considered the answers, you can choose from them to determine your health and wellness plan goals.

Please let me know if you have any questions, comments, concerns, or if you have suggestions on how to improve this assessment. New information may be added periodically, and it is subject to change without notice.

Physical Health

  • Rate your satisfaction with your overall physical health.
  • Rate your satisfaction with your sleep habits.
  • Rate your satisfaction with your exercise habits.
  • Rate your satisfaction with your weight.
  • Rate your satisfaction with your energy levels.
  • Rate your satisfaction with your physique (body and parts of your body)

Nutrition

  • Rate your satisfaction with your overall diet.
  • Rate your satisfaction with your ability to access healthy foods.
  • Rate your satisfaction with your intake of fruits and vegetables.
  • Rate your satisfaction with your intake of whole grains.
  • Rate your satisfaction with your intake of lean protein.
  • Rate your satisfaction with your intake of dairy products.
  • Rate your satisfaction with your knowledge of nutritional science.

Mental Health

  • Rate your satisfaction with your overall mental health.
  • Rate your satisfaction with your ability to manage stress.
  • Rate your satisfaction with your ability to challenge your own thinking.
  • Rate your satisfaction with your mood.
  • Rate your satisfaction with your ability to cope with challenges.
  • Rate your satisfaction with your ability to access professional help when needed. 
  • Rate your satisfaction with your overall outlook on life.

Intellectual Health

  • Rate your satisfaction with your overall intellectual health.
  • Rate your satisfaction with your ability to learn new things.
  • Rate your satisfaction with your ability to think critically.
  • Rate your satisfaction with your ability to challenge your own beliefs.
  • Rate your satisfaction with your ability to solve problems.
  • Rate your satisfaction with your overall curiosity.

Emotional Health

  • Rate your satisfaction with your overall emotional health and wellness.
  • Rate your satisfaction with your ability to express your emotions.
  • Rate your satisfaction with your ability to regulate your emotions.
  • Rate your satisfaction with your ability to connect with others emotionally.
  • Rate your satisfaction with your level of emotional intelligence.
  • Rate your satisfaction with your emotional states.

Spiritual Health

  • Rate your satisfaction with your overall spiritual health.
  • Rate your satisfaction with your contribution to the greater whole, and sense of purpose in life.
  • Rate your satisfaction with your connection to something larger than yourself.
  • Rate your satisfaction with your overall sense of health and well-being.
  • Rate your satisfaction with your ability to find peace and meaning in life.
  • Rate your satisfaction with your connection to a collective consciousness or energy.

Social Health

  • Rate your satisfaction with your overall social health.
  • Rate your satisfaction with your relationships with family and friends.
  • Rate your satisfaction with your ability to connect with others.
  • Rate your satisfaction with your ability to give and receive support.
  • Rate your satisfaction with your overall sense of belonging.
  • Rate your satisfaction with your level of social intelligence.

Relationships

  • Rate your satisfaction with your romantic relationships.
  • Rate your satisfaction with your friendships.
  • Rate your satisfaction with your family relationships.
  • Rate your satisfaction with your overall social network.
  • Rate your satisfaction with your ability to maintain healthy relationships.
  • Rate your satisfaction with your ability to set flexible and safe boundaries.

Cultural Diversity

  • Rate your satisfaction with your understanding of different cultures.
  • Rate your satisfaction with your ability to interact with people from different cultures.
  • Rate your satisfaction with your overall openness to diversity.
  • Rate your satisfaction with your ability to appreciate different perspectives.
  • Rate your satisfaction with your ability to celebrate diversity.

Occupational Health

  • Rate your satisfaction with your overall occupational health.
  • Rate your satisfaction with your job satisfaction.
  • Rate your satisfaction with your work-life balance.
  • Rate your satisfaction with your ability to manage stress at work.
  • Rate your satisfaction with your ability to understand organizational psychology.
  • Rate your satisfaction with your overall social, physical, and mental health at work.

Financial Literacy

  • Rate your satisfaction with your overall financial literacy.
  • Rate your satisfaction with your ability to manage your finances.
  • Rate your satisfaction with your ability to save money.
  • Rate your satisfaction with your ability to invest money.
  • Rate your satisfaction with your overall financial well-being.

Academic Health

  • Rate your satisfaction with your overall academic health.
  • Rate your satisfaction with your grades.
  • Rate your satisfaction with your ability to manage your time.
  • Rate your satisfaction with your ability to stay organized.
  • Rate your satisfaction with your overall motivation to learn.
  • Rate your satisfaction with your ability to maintain focus and attention on learning.

Environmental Health

  • Rate your satisfaction with your overall environmental health.
  • Rate your satisfaction with your ability to reduce your environmental impact.
  • Rate your satisfaction with your ability to live sustainably.
  • Rate your satisfaction with your ability to maintain a clean and sanitary home.
  • Rate your satisfaction with your overall connection to nature.
  • Rate your satisfaction with your overall sense of environmental well-being.

Also, this questionnaire is available or will be available in the Quenza app as an interactive exercise. Please note that this is just a general self-care assessment questionnaire. It is not a substitute for professional medical or mental health advice. If you are concerned about your health or well-being, please consult a doctor or therapist.