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* 1. Please tell me about yourself.

2. Rate your satisfaction with the following issues that typically affect wellness.

  Completely Dissatisfied Somewhat Dissatisfied Neither Satisfied Nor Dissatisfied Somewhat Satisfied Completely Satisfied N/A
Eating habits
Sleep habits
Stress management
Manage work issues
Financial issues
Depression or anxiety
Weight
Physical activity
Alcohol or drugs
Tobacco
Medications
Sense of well being (health & happiness
Specific medical conditions

3. The following traits may be helpful building blocks. Which ones are you satisfied with your capability?

4. Which of the following wellness, health, and fitness areas are you interested in for goal setting?

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