Where are you now

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Name

First Name

Last Name

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Age RangeChoose the age group to which you belong.

-44

45-55

55+

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Do you have chronic ailments that require medication? Do you have periodic attacks e.g. migraines, depression, severe perimenopause symptoms? Do you eat well and take nutritional supplements? Do you have an exercise regime?Slide the number marker along to show your rating of your own Health & Wellness with a brief comment if you want to.

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Why do you give yourself this score?

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Are you a good money manager? Do you monitor your income and expenditure? Do you save money? Are you in long term debt? Do you have a secure income? Do you have a pension or other long term income source?Slide the number marker along to show your rating of your own Money & Wealth with a brief comment if you want to.

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Comments

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Do you have a long-term partner? Are you satisfied with your love life as it is? Do you see a long-term future for the current arrangements? Do you want more from your current relationship? How far are you from your ideal relationship?Slide the number marker along to show your rating of your own Love & Intimacy with a brief comment if you want to.

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How comfortable are you with meeting strangers? Do you avoid social situations where you don’t know people? Can you speak up when required? Do you take on difficult conversations? Do you dress to fit in or please yourself?Slide the number marker along to show your rating of your own Confidence & Image with a brief comment if you want to.

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Comments

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Do you have good relations with your extended family? Do you have some family members who are critical of you or what you do? Do you have some ‘old friends’ who want to keep you on their level rather than support your choices?Slide the number marker along to show your rating of your own Family & Friends with a brief comment if you want to.

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Comments

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Are there things you would like to do if you had more time and money? Is there something or someone you wanted to be or do when you were younger, but think it is too late? Do you dream of a future life that you don’t tell people about?Slide the number marker along to show your rating of your own Passion & Purpose with a brief comment if you want to.

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Comments

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EmailSo we can send your results please enter your email address below.

example@example.com

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Thank you for completing this questionnaire.

We will send you a report to show you where you are shortly.

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