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* 1. Your Name

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* 2. Email Address

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* 3. Would you like us to add you to our Kaleo Family newsletter list?

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* 4. How would you rate your knowledge of the resources in your community that you can access?

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* 5. How would you rate your time management skills?

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* 6. I use time blocking to manage my time

 
Regularly
Sometimes
Never

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* 7. I understand the benefits of regular journaling.

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* 8. How often do you journal?

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* 9. I know how to create and track a budget.

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* 10. Do you use a budget for personal and/or household expenses?

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* 11. How often do you plan your meals in advance?

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* 12. I know how to make a meal plan.

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* 13. I have strategies to build healthy habits

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* 14. I have created healthy habits for myself

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* 15. I am taking steps to get me closer to my goals and vision.

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* 16. I understand the connection between my mental and physical well being.

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* 17. I take steps to manage my stress.

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* 18. How often do you engage in creative activities with your children?

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* 19. I understand the importance of creative play.

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* 20. I have a vision for my future and I am confident I can achieve it.

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* 21. I am aware of steps I can take to improve my life.

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* 22. I believe in my capability to take action and improve my life.

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