Health & Happiness Survey Name * First Name Last Name Email * Phone (###) ### #### Survey I am able to find moments of joy in every day. Strongly Disagree Disagree Neutral Agree Strongly Agree I am satisfied with, and maintain my social life. Strongly Disagree Disagree Neutral Agree Strongly Agree I feel nurtured and supported in my primary relationships. Strongly Disagree Disagree Neutral Agree Strongly Agree My home environment brings me comfort and relaxation. Strongly Disagree Disagree Neutral Agree Strongly Agree I cook and eat healthy meals at home. Strongly Disagree Disagree Neutral Agree Strongly Agree I make time to exercise regularly. Strongly Disagree Disagree Neutral Agree Strongly Agree I feel vibrant and am not concerned with my health. Strongly Disagree Disagree Neutral Agree Strongly Agree I am satisfied with my level of education. Strongly Disagree Disagree Neutral Agree Strongly Agree I am in a career that I enjoy. Strongly Disagree Disagree Neutral Agree Strongly Agree I am satisfied with my financial position. Strongly Disagree Disagree Neutral Agree Strongly Agree I allow my creativity to flow in areas of my life. Strongly Disagree Disagree Neutral Agree Strongly Agree I feel spiritually connected to my faith/universe/other. Strongly Disagree Disagree Neutral Agree Strongly Agree I feel content and happy with my life the majority of the time. Strongly Disagree Disagree Neutral Agree Strongly Agree Contact me regarding results Yes No By pressing submit you agree to our privacy policy. We will not share your information. All data is collected for anonymous survey data only. If you would like us to contact you regarding your results please check the 'contact me' box above. Thank you!