Transformational Balance Assessment

This is the wellness wheel. Imagine this is a wheel to a bicycle. Each section or spoke is a piece of our life that we need to be aligned and filled in order to feel balanced. If the spoke is not straight or sturdy it will be a rough ride and if a section of the tire is punctured and all the way flat, it can be disastrous!

Looking at each spoke of wellness wheel and evaluating the level of balance in your life, please arrange each spoke in order from flattest and imbalanced (1) to most stable (7).

Mark the bubble that matches to your level of balance.

Rows	1	2	3	4	5	6	7
SPIRITUAL -Spiritual wellness involves our set of beliefs, principles, and values that help give direction to our lives. It is seeking meaning and purpose in our every day lives, which ultimately encourages wellness. Topics may include compassion, morals, values, spirituality, meditation, beliefs, gratitude, self-understanding, and being at peace with nature.
EMOTIONAL -Emotional wellness includes all aspects of mental health, emotional state and well-being, as well as how they interact. In turn, your mental wellness influences how you think, feel, and behave in your daily life and affects each dimension in turn and includes coping with the normal difficulties of life. Topics may include anxiety, mood, emotions, stress management, and self-care.
GOALS & ASPIRATIONS - Goals & Aspirations wellness includes all aspects of educational and occupational enrichment and satisfaction. By preparing and making use of your gifts, skills, and talents in order to gain purpose, happiness, and enrichment in your life allows you to maintain a positive attitude, experience satisfaction & successfully integrating a commitment to your occupation into a total lifestyle that is satisfying and rewarding. Topics may include career changes and growth, pursuit of hobbies and specialty interests.
PHYSICAL -Physical wellness encompasses a variety of healthy behaviors including adequate exercise, proper nutrition and abstaining from harmful habits such as drug use and alcohol abuse. It means learning about and identifying symptoms of disease, getting regular medical checkups, and protecting yourself from injuries and harm. Topics may include meal prep, fitness routines, scheduling medical appointments, or seeking recovery from hurts, habits or hang-ups that no longer serve your new lifestyle.
SOCIAL -Social wellness refers to our ability to interact successfully in our global community and to live up to the expectations and demands of our personal roles. This means learning good communication skills, developing intimacy with others, and creating a support network of friends and family members. Topics include showing respect for others and yourself. Contributing to your community and to the world to build a sense of belonging.
ENVIRONMENT -Environmental wellness is an awareness of the unstable state of the earth and the effects of your daily habits on the physical environment. It consists of maintaining a way of life that maximizes harmony with the earth and minimizes harm to the environment. Topics include safe and clean housing, recycling, organizing and removing tangible and electronic distractions. It includes being involved in socially responsible activities to protect the environment.
FINANCIAL -Financial wellness is how our finances contribute to our overall wellness. It is the healthy relationship between your goals and your financial obligations. When someone is struggling financially, all aspects of their wellness are affected. Topics may include building a budget, paying off debt, and finding ways to increase savings.

Date

Please explain why you selected your 7 as the most stable part of your wheel right now.

Please explain why you selected your 1 as the most imbalanced part of your life right now.

List 3 goals you want to complete within 2 months.

List 5 goals you want to complete within the 6 months.

Why have you yet to be successful with your goals listed? What will be different this time?

Imagine an ideal day for you one year from now...please explain in great detail from waking to bedtime what you want to experience, eat, do, etc.

Name

First NameLast Name

Email

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Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

When you click submit, you'll be taken to the calendar to schedule a 1:1 so we can begin transforming.

TRANSFORMATION & BALANCE ASSESSMENT