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Survey on Well-being!

Total questions: 7

Worksheet time: 8mins

Name
Class
Date
1.

We know life can feel like a juggling act—balancing work, family, and everything in between. But let’s take a minute to focus on you. This short, fun survey will help us get a sense of how you’re doing. Ready?

a)

Yes

b)

No

c)

May be

d)

Always

2.

How would you describe your physical health these days?

a)

I’m a fitness ninja!

Energetic and Active

b)

Tired but Managing

c)

Run Down and Stressed

d)

In Need of Improvement

3.

How often do you make time to move (walk, dance, chase after kids)?

a)

Daily—I’m a walking cardio machine!

b)

A few times a week—depends on my caffeine level.

c)

Occasionally—life’s a bit hectic.

d)

Rarely!

4.

How much sleep are you really getting?

a)

Well-Rested and Recharged

b)

Sleeping enough but could get more

c)

Struggling with Consistent Sleep

d)

Running on Fumes

5.

Emotional Well-Being (Time for a Little Self-Reflection)

How would you rate your emotional well-being lately?

a)

Feeling zen, like a peaceful ocean

b)

Pretty balanced, but with a few stormy waves

c)

It’s a bit of a rollercoaster.

d)

Help! Send some coffee

6.

(Personal Insights)

When was the last time you did something just for yourself?

a)

Today! (Self-care is my jam)

b)

This week—I tried to fit it in.

c)

This month—it’s been a while.

d)

I don't even remember

7.

If you could give yourself one piece of advice about self-care, what would it be?

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