Shift Life: The M.A.R.C.H Survey
M - Mindset
Number the following on a scale of 1 being low and 10 being high Begin each question with: What is the level of your...?
Positivity about your current life?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Ability to attain your current goals /aspirations?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Positivity about your future?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Confidence in your choices and decisions?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Motivation in you in your daily life?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Relationship with your religion and/or spirituality?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
A - Attitude
Number the following on a scale of 1 being low and 10 being high Begin each question with: What is the level of your...?
Fulfilment from your current mindset?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Time / energy focused solely on yourself?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Ability to change / make things better?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Belief that a ‘better life’ is based on future goals being achieved?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Understanding of your capacity?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Positivity created by your current attitudes and actions?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
R- Relationships
Number the following on a scale of 1 being low and 10 being high Begin each question with: What is the quality of your relationship with your...?
Significant other Partner/spouse? (If applicable )
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Immediate family Children/dependant? (If applicable)
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Birth family Parents/siblings/ chosen family?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Extended family Cousins, Aunts /Uncles/ Grandparents? (If applicable)
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Friends?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Work colleagues?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Acquaintances Neighbours, gym peers, school parents?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Yourself?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
C - Career
Number the following on a scale of 1 being low and 10 being high Begin each question with: What is the satisfaction level in/with of your...?
Current career choice?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Current role / position ?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Salary?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Career trajectory / opportunities?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Balance/Blend of career and personal life?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Longevity of your career?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
H - Health
Number the following on a scale of 1 being low and 10 being high Begin each question with: What is the quality of your...?
Sleep (amount/quality/ ability to fall asleep)?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Mental health?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Physical health?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Emotional Health?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Time spent on your overall wellbeing?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
Overall Health?
*
1
2
3
4
5
6
7
8
9
10
Low
High
1 is Low, 10 is High
If you could make three changes in your life what would they be?
Change 1:
*
Change 2:
*
Change 3:
*
Time to Shift Life
Please fill in the following contact details and I'll be in touch to discuss how we can shift together!
Name:
*
E-mail
*
Phone
*
Save
Submit
Should be Empty: