Current Life Satisfaction Assessment

Current Life Satisfaction Assessment
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Group ID
Rate your current level of satisfaction with each of the following areas of your life from 1 – 10 using #

1 as the lowest level of satisfaction and # 10 as the highest level of satisfaction.
Rate from 1 – 10
Career*

1

2

3

4

5

6

7

8

9

10

1 is Not satisfied, 10 is Very satisfied
Quality of relationship with significant other*

1

2

3

4

5

6

7

8

9

10

1 is Not satisfied, 10 is Very satisfied
Family relationship*

1

2

3

4

5

6

7

8

9

10

1 is Not satisfied, 10 is Very satisfied
Relationship with friends *

1

2

3

4

5

6

7

8

9

10

1 is Not satisfied, 10 is Very satisfied
Physical health and well being *

1

2

3

4

5

6

7

8

9

10

1 is Not satisfied, 10 is Very satisfied
Emotional health and mental health*

1

2

3

4

5

6

7

8

9

10

1 is Not satisfied, 10 is Very satisfied
Physical environment*

1

2

3

4

5

6

7

8

9

10

1 is Not satisfied, 10 is Very satisfied
Finances and financial management*

1

2

3

4

5

6

7

8

9

10

1 is Not satisfied, 10 is Very satisfied
Spirituality and religious practices*

1

2

3

4

5

6

7

8

9

10

1 is Not satisfied, 10 is Very satisfied
Educational elevel /Personal Growth*

1

2

3

4

5

6

7

8

9

10

1 is Not satisfied, 10 is Very satisfied
Fun and Leisure time/activities*

1

2

3

4

5

6

7

8

9

10

1 is Not satisfied, 10 is Very satisfied
Healthy Lifestyle/ self-care*

1

2

3

4

5

6

7

8

9

10

1 is Not satisfied, 10 is Very satisfied
Work-Life Balance *

1

2

3

4

5

6

7

8

9

10

1 is Not satisfied, 10 is Very satisfied
When is the best time to contact you?
Describe in more detail 1 - 5 areas you’d most like to focus on in our coaching relationship.*
Level of accomplishment
Thanks for completing this assessment. I look forward to reviewing your responses with you during your complimentary discovery session. I will contact you to schedule your session.
Should be Empty:

Current Life Satisfaction Assessment

Rate from 1 – 10