The 56 Soft Challenge: Wellbeing Self-Assessment Form

Name

First Name

Last Name

example@example.com

How connected do you feel to your emotions on a daily basis?* This field is required.

Disconnected – I rarely acknowledge or understand my emotions.

Slightly Connected – I notice my emotions occasionally but struggle to process them.

Moderately Connected – I recognize my emotions but don’t always engage with them deeply.

Very Connected – I am aware of and actively process my emotions most of the time.

Deeply Connected – I consistently tune into my emotions and navigate them with clarity and intention.

How often do you intentionally process your emotions?* This field is required.For example, journaling, Soulcare, breathwork, meditation, etc.

Rarely/Never – I hardly ever engage in intentional emotional processing.

Occasionally – I process my emotions sometimes, but it’s not a regular practice.

Moderately – I engage in emotional processing fairly often but not consistently.

Consistently – I have a regular practice of processing my emotions in intentional ways.

Deeply Integrated – Emotional processing is a core part of my daily routine and self-care.

How often do you experience moments of peace and emotional balance?* This field is required.

Never

Rarely

Sometimes

Often

Daily

How well do you adapt to challenges and recover from emotional setbacks?* This field is required.

I struggle often – I find it difficult to recover from challenges and often feel stuck.

I make an effort but find it difficult – I try to adapt but often feel emotionally weighed down.

I manage but need support – I can navigate challenges, but it takes time and external guidance.

I adjust well – I find ways to work through difficulties and regain emotional balance.

I navigate challenges with ease – I move through setbacks with awareness, growth, and clarity.

Do you feel aligned with your personal values and purpose?* This field is required.

Disconnected – I often feel lost or unsure about my values and direction.

Slightly Aligned – I have some awareness of my values but struggle to live them fully.

Moderately Aligned – I try to align with my values but occasionally feel misaligned.

Very Aligned – My choices and actions mostly reflect my values and purpose.

Deeply Aligned – I am fully aligned with my values and live with clear purpose.

How often do you practice intentional stress management techniques?* This field is required.Breathwork, movement, mindfulness, etc.

Never

Rarely

Sometimes

Often

Daily

Do you feel in control of your stress levels and reactions to challenges?* This field is required.

Rarely in control – Stress often overwhelms me, and I struggle to manage my reactions.

Sometimes in control – I try to manage stress, but my reactions feel unpredictable.

Moderately in control – I handle stress fairly well but have moments where it gets the best of me.

Mostly in control – I can regulate my stress and reactions in most situations.

Fully in control – I manage stress intentionally and respond to challenges with calm and clarity.

How would you rate your ability to navigate difficult emotions?* This field is required.

I feel overwhelmed – Difficult emotions often consume me, and I struggle to process them.

I avoid them – I recognize my emotions but tend to suppress or ignore them.

I manage with effort – I can work through emotions, but it takes time and conscious effort.

I navigate them well – I acknowledge and process difficult emotions in a healthy way.

I embrace and transform them – I fully engage with my emotions, using them for growth and self-awareness.

How often do you experience prolonged stress or overwhelm?* This field is required.

Almost Always – I frequently feel overwhelmed, and stress feels constant.

Often – I experience stress regularly, and it lingers for long periods.

Sometimes – I go through periods of stress, but I can manage them.

Rarely – I experience stress occasionally, but it doesn’t last long.

Almost Never – I handle stress well, and it rarely feels overwhelming.

How supported do you feel in managing daily stressors?* This field is required.

Not supported at all – I feel like I have to manage everything on my own with no support.

Slightly supported – I have some support, but it doesn’t always meet my needs.

Moderately supported – I have resources and people I can turn to, but I still struggle at times.

Well supported – I have consistent support that helps me navigate stress effectively.

Fully supported – I feel deeply supported and have all the tools and community I need to manage stress well.

How often do you engage in intentional movement?* This field is required.Walking, stretching, yoga, strength training, dance, etc.

Never — 0 days a week.

Rarely — 1 to 2 days a week

Sometimes — 2 to 3 days a week

Often — 4 to 5 days a week

Always — 7 days a week.

Do you feel physically energized after movement?* This field is required.

Not at all

Slightly

Moderately

Very

Completely

How would you rate your current fitness level?* This field is required.

Beginner — You are new to fitness or just starting to build a consistent movement routine.

Intermediate — You have some experience with fitness and engage in regular movement but are still developing consistency or technique.

Rebuilding — for those who may have had a strong fitness level in the past but are currently starting over or regaining consistency.

Advanced — You have a strong and consistent fitness routine, with a good understanding of movement, endurance, and strength training.

Expert — You have mastered fitness fundamentals, train at a high level, and may have experience in coaching, competing, or specialized training.

Is your current movement practice enjoyable or fulfilling?* This field is required.

Not at all

Slightly

Sometimes

Often

Completely—I love my movement practice.

How confident do you feel in your ability to sustain an active lifestyle?* This field is required.

Not at all

Slightly

Moderately

Very

Completely

How often do you eat whole, nutrient-dense foods that support your well-being?* This field is required.

Never

Rarely

Sometimes

Often

Everyday

Do you make intentional food choices that align with your body’s needs?* This field is required.

Never

Rarely

Some meals

Most meals

Every meal

How mindful are you when eating? * This field is required.(e.g., eating without distractions, listening to fullness cues).

Not at all

Slightly

Moderately

Very

Completely

How well does your current relationship with food support your overall well-being?* This field is required.

Not at all

lightly

Moderately

Very

Completely

Do you feel satisfied and nourished after meals?* This field is required.

Not at all

Slightly

Moderately

Very

Completely

How often do you drink enough water to feel fully hydrated throughout the day?* This field is required.

I don't drink water.

Does seltzer water count?

Some days

Most days

Everyday

Do you choose water or hydrating beverages over dehydrating options?* This field is required.For example, sodas, excessive caffeine)?

Never

Rarely

Sometimes

Often

Everyday

Do you wake up feeling hydrated and refreshed?* This field is required.

Never

Rarely

Sometimes

Often

Everyday

How well do you listen to your body’s thirst cues?* This field is required.

Never

Rarely

Sometimes

Often

Everyday

How often do you "eat your water"?* This field is required.For example, incorporating hydrating fruits such as papaya, cucumber, cantaloupe, and pineapple into your food choices.

Never

Rarely

Sometimes

Often

Everyday

How often do you get 7-9 hours of restful sleep?* This field is required.

Never

Rarely

On the weekends and days off

Most days

Everyday

Do you wake up feeling rested and restored?* This field is required.

Never

Rarely

On the weekends

Most days

Everyday

How would you rate the quality of your sleep overall?* This field is required.

Poor – I rarely wake up feeling rested, and my sleep is often disrupted.

Fair – My sleep is inconsistent, and I sometimes struggle with feeling well-rested.

Good – I get decent sleep most nights, but there’s room for improvement.

Very Good – I sleep well consistently and wake up feeling refreshed most mornings.

Excellent – My sleep is deep, restorative, and supports my overall well-being.

How consistent is your sleep routine (going to bed/waking up at the same time)?* This field is required.

Not at all consistent

Slightly consistent

Moderately consistent

Mostly consistent

Very consistent

Do you limit screen time and overstimulation before bed?* This field is required.

Never

Rarely

Sometimes

Often

Always

How kind and forgiving are you toward yourself when you make mistakes?* This field is required.

Very self-critical – I struggle to let go of mistakes and often blame myself.

Somewhat harsh – I try to be kind, but I tend to dwell on my mistakes.

Neutral – I acknowledge my mistakes but don’t always extend myself grace.

Mostly compassionate – I accept mistakes as part of growth and practice self-forgiveness.

Fully self-compassionate – I embrace mistakes as learning opportunities and treat myself with kindness.

Do you actively practice self-love and self-affirmation?* This field is required.

Rarely or never – I struggle with self-love and don’t affirm myself often.

Occasionally – I engage in self-love practices but not consistently.

Moderately – I practice self-love sometimes but could do it more often.

Regularly – I actively affirm myself and nurture self-love in my daily life.

Deeply and consistently – Self-love is a priority, and I intentionally uplift myself every day.

How often do you engage in personal development and self-reflection?* This field is required.

Rarely – I don’t engage in personal growth or self-reflection often.

Occasionally – I reflect on my growth sometimes but not with consistency.

Moderately – I make an effort to develop myself but could be more intentional.

Regularly – Personal growth and self-reflection are an important part of my routine.

Consistently and intentionally – I prioritize self-reflection and continuous learning as a way of life.

Do you believe in your ability to change and improve your habits?* This field is required.

Not at all – I doubt my ability to change and often feel stuck.

Slightly – I want to believe I can change, but I struggle with self-doubt.

Somewhat – I believe in my ability to grow, but it feels challenging at times.

Strongly – I know I can change and improve my habits with effort.

Completely – I have full confidence in my ability to evolve and transform my life.

How committed do you feel to making sustainable lifestyle shifts over the next 8 weeks?* This field is required.

Somewhat committed – I want to change but struggle with motivation.

Moderately committed – I’m willing to make changes but need accountability.

Highly committed – I am ready to take action and stay consistent.

Fully committed – I am all in and dedicated to transforming my well-being.

What are your current health goals* This field is required.

I want to feel more energized throughout the day.

I’d like to lose weight in a healthy, sustainable way.

I’m trying to get better, deeper sleep.

I want to improve my gut health and digestion.

I’m focused on building a consistent workout routine.

I want to eat more nourishing, whole foods.

I’m focused on regulating my hormones and cycle.

I’m healing my relationship with my body.

I’m working on managing stress and anxiety naturally.

I’m learning to set boundaries and protect my peace.

Scoring & Interpretation35-70: There is room for deep transformation. Use this challenge to focus on small, meaningful shifts. 71-105: You have solid habits in place but can deepen your commitment in specific areas. 106-140: You are already embodying many of the principles of well-being. Focus on consistency and fine-tuning. 141-175: You are thriving! Continue to refine, elevate, and expand your practices.