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* 1. What is your age?

* 2. On a scale from 0-5, how much vitality do you feel in your daily life? If 0 (represented by the star at the left-hand end) was exhausted and in bed and 5 (represented by the star at the right-hand end) was feeling highly energised and exuberant about life ready to take on new pursuits and opportunities?

* 3. What do you feel is the cause of any lack in vitality you might be feeling?

* 4. When you think about daily life – at home and work – what percentage of time would you feel tense every day?  (slide the button to indicate your experience)

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

* 5. When you think about daily life – at home and work – what percentage of time would you feel tired, with little energy to do anything YOU enjoy, every day?  (slide the button to indicate your experience)

0 Tired, with little energy to do anything I enjoy
i We adjusted the number you entered based on the slider’s scale.

* 6. When you think about daily life – at home and work – what percentage of time would feel stressed every day?  (slide the button to indicate your experience)

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

* 7. When you think about daily life – at home and work – what percentage of time would you feel overwhelmed every day?  (slide the button to indicate your experience)

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

* 8. When you think about daily life – at home and work – what percentage of time would you feel on the verge of crying or shouting every day?  (slide the button to indicate your experience)

0 Crying or Shouting
i We adjusted the number you entered based on the slider’s scale.

* 9. When you think about daily life – at home and work – what percentage of time would you feel burnt out, with little energy to do anything you enjoy every day?  (slide the button to indicate your experience)

0 Burnt out with no energy
i We adjusted the number you entered based on the slider’s scale.

* 10. What would you like your vitality in daily life to be on a scale from 0-5? If 0 (represented by the star at the left-hand end) was exhausted and in bed and 5 (represented by the star at the right-hand end) was feeling highly energised and exuberant about life ready to take on new pursuits and opportunities?

* 11. What do you feel are the negative impacts or consequences for you when you feel a lack of vitality?

* 12. How do you feel this affects others?

* 13. What do you feel are the positive impacts or benefits of feeling more vital?

* 14. When you think about, or feel "overwhelmed", what exactly does it mean to you? (Even a couple of words will help us understand exactly how you feel.)

* 15. What sort of things have you tried to help you feel more vital?

* 16. Have any of these worked for you?

* 17. Can you explain what worked for you and why?

* 18. Can you explain what didn't work for you and why?

* 19. When you think about feeling more vital how hopeful are you of finding a solution?

* 20. On a scale from 0-5 - how valuable would it be for you to have some techniques that could help you feel more vital every day? If 0 was "no value whatsoever" (represented by the star at the left-hand end) and 5 was "highly valuable, please show me how to do it now!"

* 21. If you were to take part in a program to help you feel more revitalised what would you like to see in it?

* 22. If you were to take part in a program that could help you increase your vitality what delivery style would work best for you? (please rank order your preferences - with 1 being most appealing to 8 being least appealing

* 23. If you were to take part in a weeknight or weekend workshop – that would give you some time out for you and help you learn something that would help make your life easier and more enjoyable – what type of topics would you like to see covered?

* 24. Which of the following best describes your current relationship status?

* 25. Thank you very much for your response to our survey. Your time is greatly appreciated. If you would like to keep in touch with the project and its outcomes feel free to share your email address here.

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