GAUYAFIT HOLISTIC FITNESS ASSESSMENT Survey

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* 1. Let me get to know you

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. I have exciting dreams and goals to look forward to

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* 3. I am self-aware and enjoy living in the moment (I don't dwell on the past or the future).

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* 4. I feel a strong sense of purpose in my life

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* 5. I am in control of most things in my life

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* 6. Humor, laughter and playfulness are part of my daily life

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* 7. I live my life with passion and joy

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* 8. I am an optimistic person.

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* 9. I feel like my life is in balance physically, mentally, emotionally and spiritually.

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* 10. When my life feels, "out of control" or overly stressful, I choose healthy behaviors to help me re-center, relax and renew

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* 11. I find positive ways to deal with stress (e.g., exercise, meditation, yoga, spending time in nature or other stress-reducing practices).

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* 12. Negative stress and over-whelm are problems for me.

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* 13. I am the Captain of my ship. I know that I am responsible for my own happiness and well-being.

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* 14. I am physically able to do everything I want to do in my life.

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* 15. I exercise at least five days a week on a regular basis

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* 16. I eat a healthy, balanced diet made up of mostly unprocessed healthy foods (e.g., vegetables, fruits, high-fiber whole grains and carbohydrates, healthy fats and high-quality protein).

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* 17. I drink at least 8 x 8 oz. glasses of plain water most days.

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* 18. I have plenty of energy to get myself through the day and do the activities that I want to do with ease.

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* 19. My digestion and gut health rarely give me trouble.

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* 20. I sleep 6-8 hours most nights.

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* 21. I have health challenges that impact my lifestyle significantly (e.g., high BP, diabetes, anxiety/depression, sleep apnea, high cholesterol or triglycerides, orthopedic issues, chronic headaches or pain).

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* 22. I have plenty of support and accountability to help me reach my health-, fitness- and wellness goals.

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* 23. I have faith in a Higher Power that sustains me.

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* 24. My significant other/spouse/partner always has my best interests in mind and wants to see me evolve, grow and learn new skill, habits and become my BEST self.

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* 25. My close friends and family always have my best interests in mind and want to see me evolve, grow and learn new skills and habits.

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