Rate each major life area from 1 to 10, where 1 means it’s an extreme problem and 10 means it’s right where you want it to be. Choose the number that best reflects how you feel that things are going in each major life area.
| Legal |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Financial |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Family/Friends |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Leisure |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| School/Job |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Physical Health |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Emotional Health |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Spiritual |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
Now choose the three major life areas from above that are the biggest problems for you, and answer the following questions for each one.
| Major life areas |
Answers to questions |
| 1. What can I do to move one point up on the scale? |
| a) |
a) |
| b) |
b) |
| c) |
c) |
|
2. Who will support me in that change? |
| a) |
a) |
| b) |
b) |
| c) |
c) |
|
3. What would be different about the major life area after the change? |
| a) |
a) |
| b) |
b) |
| c) |
c) |
