Life Balance

 

This Life Balance questionnaire is your chance to give Susan a sense of who you are, what you're about, and where you may want support. The questions cover a very broad spectrum of important life areas. This is key because we view all issues, both positive and negative, as making up a part of the complete picture of who we are. We also know that certain areas of life impact others. It's for that reason too we're interested in getting to know you. To get a picture of the balance of the key elements in your life, please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot. When appropriate, select 11 for the N/A response.

Thank you for taking the time to complete this form!

Name *
Name
Please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot.
Please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot.
Please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot.
Please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot.
Please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot.
Please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot.
Please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot.
Please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot.
Please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot.
Please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot.
Please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot.
Please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot.
Please rate the following areas 1-10 where 1 is poor/negative or very little and 10 is excellent/positive or a lot.