I hold and carry responsibilities and commitments to many other people, often leaving little time for myself.

True

False

Self-care is not a consistent or regular part of my life's routine.

True

False

I would like to improve the practice of making my needs and wants more of a priority.

True

False

I know there's something MORE for my me and my life, I just don't know WHAT it is.

True

False

I've achieved success, and often find myself wondering, "Now what?"

True

False

It's hard to find time to regularly participate in hobbies / activities outside of responsibilities.

True

False

I often feel like I am just "going through the motions" of life and/or my responsibilities.

True

False

My life is centered around meeting the needs of others.

True

False

Finding time for what's important to me often seems impossible.

True

False

I feel resentful towards others.

True

False

Taking a "Sick Day" is not an option in work and/or home life.

True

False

I want things need to be different, but don't know how to make it happen.

True

False

I wish I had more time to be physically active.

True

False

My daily routine doesn't reflect my values and priroities.

True

False

It's hard to set aside time for relaxation, mindfulness or reflection.

True

False

I have goals and dreams that I am working towards, but they aren't yet realized.

True

False

I value personal growth and self-improvement.

True

False

I feel confident in my abiity to create positive change in my life.

True

False

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