E-Based Consulting

Well-Being Survey

Welcome to the Well-Being Survey, this is an opportunity to reflect on multiple dimensions of your life at the one time.

This survey will take about 5 minutes to complete and will ask you to think about how you spend your time today over 10 life dimensions identified - Family, Sensing, Work, Adventure, Socialising, Body, Spirituality, Mind, Relating and Money.

The purpose of the survey is to become aware of how you are allocating time across different life dimensions that support your overall well being.

0, - Never

1 - Sometimes

2 - Often

3 - Very Often

4 - Always

Please click on the appropriate answer from 0 to 4 for each question, which best reflects your current experiences.

Please enter your name:

FAMILY			0	1	2	3	4
	1	I manage my personal and work commitments to spend sufficient time with my family.
	2	I am able to be there for my family at the right times.
	3	I am satisfied with the relationships I have (had) with my parents.

SENSING
	4	I notice the detail of my natural surroundings.
	5	I use any physical symptoms I experience as a message to alter my behaviour.
	6	I use touch to explore and understand my environment.

WORK
	7	Work takes up more than 50% of my waking time.
	8	I take personal responsibility for my own career development.
	9	I work towards a set of objectives, which are aligned with those of the organisation.

ADVENTURE
	10	I work outside my comfort zone.
	11	I try new outdoor / indoor experiences.
	12	I take calculated risks.

SOCIALISING
	13	Interaction with others is important to me.
	14	I actively manage my social contacts.
	15	I spend quality time with my colleagues/ friends and family.

BODY			0	1	2	3	4
	16	I exercise at least 3 to 4 times per week.
	17	I have a high fibre diet that maximises my energy levels: e.g. fruit, vegetables, breads, protein.
	18	I perform relaxation techniques at least 3 times per week.

SPIRITUALITY
	19	I am clear about my values (what is most dear and important to me).
	20	I make changes to my behaviours where they are inconsistent with my values.
	21	My life has purpose.

MIND
	22	I measure my own worth without comparing myself to other.
	23	I see things from different perspectives to widen my view of possibilities.
	24	I am able to not worry about a problem that I can do nothing about.

RELATING
	25	I seek to understand others views or comments before trying to express my views.
	26	I am aware of the impact of my non-verbal communication.
	27	I listen to people, without interrupting them.

MONEY
	28	I spend what I can afford.
	29	I invest 5-10% of my regular income.
	30	I invest in a suitable plan for later life.