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Self Care Assessment

Self Care assessment. Where are you on your self-care journey?

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Your Information

Name

Email

Question 3 of 10

Do you currently have a self-care practice?

A

Yes

B

No

Question 4 of 10

If you answered yes, briefly describe your practice.

Question 5 of 10

Do you exercise?

A

Yes

B

No

Question 6 of 10

If you answered yes to the question. How often do you exercise?

A

once or twice a week.

B

Three times a week or more

Question 7 of 10

Do you start your day with a morning ritual or routine?

A

Yes

B

No

Question 8 of 10

On a scale of 1-10, how satisfied are you with your life?

A

1-5

B

6-10

Question 9 of 10

What area of your life are you the least satisfied with?

A

Work/Career

B

Relationships

C

Personal growth

Question 10 of 10

When is the last time you laughed?

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