Dr. C's Well-Being Pulse Check
This short-and-sweet survey will enable you to check-in with your well-being -- so you can track your well-being over time. This is especially helpful if you are committed to taking your well-being to the next level -- because it gives us a baseline to compare your results against. Ready to begin? Great! Let's get started.
Start
 
What is your first name? *

 
And what is your last name, {{answer_QZucbXxQvjnX}}? *

 
When you think of the term well-being, what does it mean to you? *

 
How would you describe your overall well-being? *

 
If you had a magic wand and you could improve your well-being in any possible way, how would you use the magic wand? *

 
{{answer_QZucbXxQvjnX}}, you will now be shown a series of statements about your well-being,

Please read them each carefully and rate the extent to which you agree or disagree with each of them.
 
Well-Being Self-Appraisal

 
Over the last two weeks, I have felt cheerful and in good spirits. *

 
Over the last two weeks, I have felt calm and relaxed.  *

 
Over the last two weeks, I have felt active and vigorous. *

 
Over the last two weeks, I woke up feeling fresh and rested. *

 
My daily life has been filled with things that interest me  *

 
My closest friends and family members would rate my overall well-being as:
*

The scale is 1 - 5 points; the higher the number the better the well-being.





 
The people I work with would rate my overall well-being as: *

The scale is 1 - 5 points; the higher the number the better the well-being.





 
Goal Accomplishments

 
How would you rate your overall self-care for the past year? *

Please answer based on your conceptualize 'self-care' -- which could include medical care, fitness activities, nutrition, sleep, or other areas of self-care that are important to you.
 
{{answer_QZucbXxQvjnX}}, what would you say was your most significant accomplishment in your work last year? *

 
{{answer_QZucbXxQvjnX}}, what would you say was your most significant accomplishment in your life last year? *

 
Where do you spend most of your "work" time? (Include both paid and unpaid work). *

If you do not see a category that applies to you, please write in a category in the "other" section.






 
What is your job title? *

 
Goal Setting & Development Planning

 
What goals would you like to set for yourself and your well-being for the next year? *

You can focus on your overall work/life balance and well-being, or on a specific dimension: Physical, Financial, Social, Mental, Purpose, Emotional
 
What is the biggest challenge you face in managing your well-being -- and thriving? *

 
Which dimensions (types) of your well-being would you like to improve the most? *


Great job completing the survey {{answer_QZucbXxQvjnX}}

If you would like a summary report of your responses to be sent to you -- as well as an explanation of what your score means -- please be sure to click on the "Please email me" button below.


I'm so glad I could help you to take care of yourself today - by tracking how well your well-being is doing. You can also learn more about your well-being in my workshops -- learn registration details on my website at www.DrSuzieCarmack.com

Dr. Suzie Carmack, PhD, MFA, MEd, ERYT
Yes! Please email me my results.