10 P E R S ON A L G R OU N DWO R K F O R C OAC H I N G HEALTH & WELLNESS WEIGHT: Low (0) to High (5) 0 1 2 3 4 5 I only eat things I feel are healthy and good for me (95%+ of the time). 0 1 2 3 4 5 I am well informed about nutrition and proper supplements. 0 1 2 3 4 5 I am up to date on all my preventative care (mammogram, prostate, dental, pap-test, cholesterol, hearing, stress test, etc.) 0 1 2 3 4 5 I have a healthy body image 0 1 2 3 4 5 I get the proper amount of physical exercise. 0 1 2 3 4 5 I do not have an excessive amount of stress. 0 1 2 3 4 5 I get enough quality sleep time. 0 1 2 3 4 5 I take enough time off work to feel rested and revitalized. 0 1 2 3 4 5 I am rarely tired. 0 1 2 3 4 5 I do not use any substances in such a way that they are harmful to me (smoking, drugs, alcohol, caffeine, sugar, etc.) 0 1 2 3 4 5 I do not work excessive hours each week. 0 1 2 3 4 5 I laugh every day (not a chuckle or a guffaw – a REAL laugh!) 0 1 2 3 4 5 I am not harboring any physical conditions that I feel are abnormal that have not been fully checked out by a proper medical specialist. 0 1 2 3 4 5 I do not have chronic pain or any chronic condition which is not being treated in the best possible way. 0 1 2 3 4 5 The time I take off from work is spent in ways that nourish and re-energize me. 0 1 2 3 4 5 I am usually optimistic and in a good mood (95%+ of the time). 0 1 2 3 4 5 I take extremely good care of myself with the extras (massages, bubble baths, pedicures, facials, meditation, fresh air, sunshine, etc.) 0 1 2 3 4 5 I rarely get sick. 0 1 2 3 4 5 I dress comfortably each day. 0 1 2 3 4 5 I smile a lot. 0 1 2 3 4 5 I always have something to look forward to. 0 1 2 3 4 5 I have plenty of interests outside of my work. 0 1 2 3 4 5 I don’t wait to the last minute or let things build to a pressure point before I take care of them. 0 1 2 3 4 5 I don’t have any habits that interfere with my wellbeing. 0 1 2 3 4 5 I have received adequate psychological counseling in the area(s) I have needed it. 0 1 2 3 4 5 0 1 2 3 4 5 0 1 2 3 4 5 0 1 2 3 4 5 TOTAL LOAD
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