You can always press Enter⏎ to continue
State of the Heart
1
Name
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
2
Email
*
This field is required.
example@example.com
Previous
Next
Submit
Press
Enter
3
Choose a symbol that reflects your heart's state regarding romantic relationships:
*
This field is required.
Romantic Emotions and Wellbeing
Padlock
Cracked heart
Bandaged heart
Glowing heart
Previous
Next
Submit
Press
Enter
4
What does the future of your heart feel like when thinking about a partnership?
*
This field is required.
Romantic Emotions and Wellbeing
Uncertain
Daunting
Promising
Bright
Previous
Next
Submit
Press
Enter
5
What does love with someone else feel like for you right now?
*
This field is required.
Romantic Emotions and Wellbeing
Unreachable
Painful longing
Slow recovery
Warm embrace
Previous
Next
Submit
Press
Enter
6
Pick a word that defines your current love life:
*
This field is required.
Romantic Emotions and Wellbeing
Stagnant
Turbulent
Restorative
Harmonious
Previous
Next
Submit
Press
Enter
7
Choose a destination that most closely mirrors your emotional journey:
*
This field is required.
Self-Love Emotions and Wellbeing
Isolation Island
Valley of Tears
Healing Haven
Summit of Serenity
Previous
Next
Submit
Press
Enter
8
Which best describes your current emotional state when you think about love?
*
This field is required.
Self-Love Emotions and Wellbeing
Numb or nonexistent
Painful or shattered
Restorative or mending
Contentment or anticipation
Previous
Next
Submit
Press
Enter
9
Pick an emotion that most closely dominates your heart right now:
*
This field is required.
Self-Love Emotions and Wellbeing
Fear
Grief
Hope
Joy
Previous
Next
Submit
Press
Enter
10
Where do you feel you are today with your ability to accept and love yourself?
*
This field is required.
Self-Love Emotions and Wellbeing
I’m disgusted with many aspects of myself and often feel guarded and not sure what love feels like anymore
I’m disappointed with how I’m behaving and often feel unworthy or undeserving of love and compassion
I know I’m often hard on myself and am learning to forgive myself for mistakes and shortcomings
I’ve released all aspects of self judgment and feel I’ve mastered self-love
Previous
Next
Submit
Press
Enter
11
How would you describe your current connection with family members?
*
This field is required.
Family Dynamics and Emotional Wellbeing
Detached and distant
Strained and conflicted
Reconciliation and forgiveness
Supportive and harmonious
Previous
Next
Submit
Press
Enter
12
Which statement best describes your feelings toward family gatherings?
*
This field is required.
Family Dynamics and Emotional Wellbeing
Avoidance and disinterest
Painful reminders of disagreements and heartache
Open to healing conversations
Enjoyable and supportive experiences
Previous
Next
Submit
Press
Enter
13
How do you perceive the overarching role of family in your emotional well-being?
*
This field is required.
Family Dynamics and Emotional Wellbeing
Non-essential and irrelevant
Source of additional stress and strain
Supportive and embrace healing
Pillar of strength and comfort
Previous
Next
Submit
Press
Enter
14
Which emotions most closely represent your current family relationships?
*
This field is required.
Family Dynamics and Emotional Wellbeing
Apathy and distant
Sadness and grief
Hopeful and optimistic
Love and comfort
Previous
Next
Submit
Press
Enter
15
Choose what best describes your communication with family members:
*
This field is required.
Family Dynamics and Emotional Wellbeing
Silent and ambiguous
Tense and conflicted
Open and honest
Warm and engaging
Previous
Next
Submit
Press
Enter
16
How would you describe your current emotional engagement at work or team projects?
*
This field is required.
Workplace Emotions and Well-being: If you do not currently work, reflect on community engagements or project teams you participate on
Keep to myself and only participate when required
Overwhelmed with sadness or frustration
Seeking a positive shift, open to opportunities
Motivated, engaged, and fulfilled
Previous
Next
Submit
Press
Enter
17
Which statement best reflects your feelings toward your professional relationships?
*
This field is required.
Workplace Emotions and Well-being
Limited connection, prefer to keep distance
Strained relationships causing emotional distress
Working towards resolution and harmony
Positive, supportive connections
Previous
Next
Submit
Press
Enter
18
How do work interactions impact your overall emotional state?
*
This field is required.
Workplace Emotions and Well-being
Minimally, no significant impact
Aggravates existing heartbreak and stress
Offers a sense of healing and resolution
Uplifting and positive experiences
Previous
Next
Submit
Press
Enter
19
Which statement best captures your recent interactions with friends?
*
This field is required.
Friendship Dynamics and Emotional Well-being
Share limited amounts of personal information
Filled with tension and unresolved issues
Actively working on rebuilding connections
Positive, enjoyable moments often filled with shared laughter and love
Previous
Next
Submit
Press
Enter
20
How do you view the impact of friends on your emotional well-being?
*
This field is required.
Friendship Dynamics and Emotional Well-being
Negligible, not a significant factor
Contributing to stress and emotional turmoil
Potential for support, growth, and healing
Empathetic while contributing to my emotional strength and happiness
Previous
Next
Submit
Press
Enter
21
How do you currently feel about reaching out to your friends in general?
*
This field is required.
Friendship Dynamics and Emotional Well-being
Uninterested in making heartfelt connections
Hesitant, anticipating potential conflict
Eager, hoping for positive reconnection & making new ones
Excited to nurture strong connections & share
Previous
Next
Submit
Press
Enter
22
You have scored {highestSelection} on the following personality/personalities
A
B
C
D
Previous
Next
Submit
Press
Enter
23
Calculation value of the selected option on each field separated by a comma
Previous
Next
Submit
Press
Enter
24
Selected A on each question
A1
A5
A2
A6
A3
A7
A4
A8
A9
A10
A11
A12
A13
A14
A15
A16
A17
A18
A19
Previous
Next
Submit
Press
Enter
25
Personality A total selection count
Previous
Next
Submit
Press
Enter
26
Selected B on each question
B1
B2
B3
B4
B5
B6
B7
B8
B9
B10
B11
B12
B13
B14
B15
B16
B17
B18
B19
Previous
Next
Submit
Press
Enter
27
Personality B total selection count
Previous
Next
Submit
Press
Enter
28
Selected C on each question
C1
C5
C2
C6
C3
C7
C4
C8
C9
C10
C11
C12
C13
C14
C15
C16
C17
C18
C19
Previous
Next
Submit
Press
Enter
29
Personality C total selection count
Previous
Next
Submit
Press
Enter
30
Selected D on each question
D1
D2
D3
D4
D5
D6
D7
D8
D9
D10
D11
D12
D13
D14
D15
D16
D17
D18
D19
Previous
Next
Submit
Press
Enter
31
Personality D total selection count
Previous
Next
Submit
Press
Enter
32
Insert A, if A = Highest selection count
Previous
Next
Submit
Press
Enter
33
Insert B, if B = Highest selection count
Previous
Next
Submit
Press
Enter
34
Insert C, if C = Highest selection count
Previous
Next
Submit
Press
Enter
35
Insert D, if D = Highest selection count
Previous
Next
Submit
Press
Enter
36
Highest selection count
Previous
Next
Submit
Press
Enter
37
Personality OR Personalities with the highest selection count
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
37
See All
Go Back
Submit