Personal Health Inventory

Envisioning your ideal health, then assessing where you are now and where you want to be is a good place to start when you've decided to make some changes to benefit your health and well-being.

Complete the following questions as best as you can.  

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* I have set aside apx. 8-10 minutes for myself to complete the following introspective questions. Your responses are confidential and will only be shared back with you (if you choose).

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* How do I picture my ideal health?
-How would I like to feel?
-How would I like to look?
-What activities am I engaging in?

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* What is most important as I think about the picture of my ideal health? 
-What do I value?
-What are my motivators?

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* For each area, please take a moment to assess Where You Are Now and Where You Would Like To Be, on a scale of 1 (low) to 10 (high). 

Where am I now regarding: Mindfulness (being tuned into the present moment, paying attention to what I'm doing while I'm doing it).

0 10
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i We adjusted the number you entered based on the slider’s scale.

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* Where would I like to be regarding: Mindfulness?

0 10
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i We adjusted the number you entered based on the slider’s scale.

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* Where am I now regarding: Physical Activity (activities of daily movement such as cleaning, gardening, etc. and exercise activities such as yoga, walking, muscle strengthening, etc.)

0 10
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i We adjusted the number you entered based on the slider’s scale.

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* Where would I like to be regarding: Physical Activity

0 10
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i We adjusted the number you entered based on the slider’s scale.

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* Where am I now regarding: Rest/Sleep (adequate rest and relaxation).

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i We adjusted the number you entered based on the slider’s scale.

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* Where would I like to be regarding: Rest/Sleep

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i We adjusted the number you entered based on the slider’s scale.

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* Where am I now regarding: Nutrition (eating a balanced, healthy diet).

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i We adjusted the number you entered based on the slider’s scale.

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* Where would I like to be regarding: Nutrition

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i We adjusted the number you entered based on the slider’s scale.

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* Where am I now regarding: Personal & Professional Development (growing and developing my abilities, talents, and interests in both my personal life and at work).

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i We adjusted the number you entered based on the slider’s scale.

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* Where would I like to be regarding: Personal & Professional Development

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i We adjusted the number you entered based on the slider’s scale.

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* Where am I now regarding: Physical Environment (how my environment impacts my health- clutter, safety, light, noise, etc.)

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i We adjusted the number you entered based on the slider’s scale.

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* Where would I like to be regarding: Physical Environment?

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* Where am I now regarding: Relationships (spending time with my family, friends, co-workers who are supportive, and with whom I communicate effectively).

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i We adjusted the number you entered based on the slider’s scale.

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* Where would I like to be regarding: Relationships

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i We adjusted the number you entered based on the slider’s scale.

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* Where am I now regarding: Mental/Emotional Wellness (how I adapt to stress and everyday life).

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i We adjusted the number you entered based on the slider’s scale.

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* Where would I like to be regarding: Mental/Emotional Wellness

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i We adjusted the number you entered based on the slider’s scale.

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* Where am I now regarding: Spirituality (seeing purpose and meaning in something larger than myself. This might include a religious affiliation, or other areas such as nature or the arts).

0 10
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i We adjusted the number you entered based on the slider’s scale.

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* Where would I like to be regarding: Spirituality

0 10
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i We adjusted the number you entered based on the slider’s scale.

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* What stands out as significant about where I am currently in the areas assessed?

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* If nothing changes in my health and well-being choices, what will my health be like in 5-10 years?

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* If I make significant changes, what will my health be like in 5-10 years?

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* What areas would I like to begin working on this year?

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* Which area would I like to begin working on in the next 3 months?
(Choose 1 area that feels most important right now)

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* I am between the ages of

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* Please email me My Personal Health Inventory (Make sure to give us your best email address below if you elect yes).

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* How did you hear about Sophrosyne Wellness?

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* * I give Sophrosyne Wellness permission to contact me, which may include unencrypted personal health information that I have shared in this inventory.

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