How Prepared am I?
One Response Preparedness Survey
Health/Fitness
How consistent are your daily habits (nutrition, exercise, rest) with your personal values and goals?
*
Not at all
Somewhat
Moderate
Mostly
Very
How confident are you in your ability to physically perform in an emergency (e.g., run, lift, carry, climb)?
*
Not at all
Somewhat
Moderate
Mostly
Very
How resilient do you feel when facing stress, uncertainty, or sudden challenges?
*
Not at all
Somewhat
Moderate
Mostly
Very
How balanced do you feel across physical, mental, emotional, and spiritual health?
*
Not at all
Somewhat
Moderate
Mostly
Very
How disciplined are you with sleep, hydration, and recovery practices?
*
Not at all
Somewhat
Moderate
Mostly
Very
I maintain a balanced diet with sufficient protein, carbohydrates, fats, vitamins, and minerals.
*
True
False
I exercise at least 3 times per week, including strength, endurance, and mobility training.
*
True
False
I can comfortably run 1–2 miles without stopping.
*
True
False
I can carry 30–50 lbs for at least 1 mile.
*
True
False
I practice stress-reduction techniques (breathing, meditation, prayer, mindfulness, etc.).
*
True
False
I have regular medical checkups and know my current health status.
*
True
False
I avoid addictions that reduce resilience (smoking, excessive alcohol, etc.).
*
True
False
I have strong social/family support that contributes to my emotional stability.
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True
False
I have a spiritual or guiding framework that helps me stay grounded in crisis.
*
True
False
HEALTH/FITNESS - My Preparedness Score
Financial Stability and Freedom
How confident are you in your ability to cover all living expenses without stress?
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Not at all
Somewhat
Moderate
Mostly
Very
How financially flexible are you if faced with sudden expenses (repairs, medical, relocation)?
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Not at all
Somewhat
Moderate
Mostly
Very
How confident are you that you’ll still meet financial needs if your income stopped for 3 months?
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Not at all
Somewhat
Moderate
Mostly
Very
How clear are your long-term financial goals and strategy?
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Not at all
Somewhat
Moderate
Mostly
Very
How secure do you feel in your job, investments, or income sources?
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Not at all
Somewhat
Moderate
Mostly
Very
I have at least 3–6 months of emergency savings.
*
True
False
I have minimal or no high-interest debt.
*
True
False
I have multiple income streams (job, side hustle, investments, etc.).
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True
False
I have financial insurance (health, disability, life, property) to cover emergencies.
*
True
False
I have a working household budget that I regularly review.
*
True
False
I have cash reserves available in case ATMs or banks are inaccessible.
*
True
False
I store some assets outside the banking system (precious metals, physical goods).
*
True
False
I understand basic economics and how inflation/markets affect me.
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True
False
I have a long-term financial plan (retirement, debt-free living, investments).
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True
False
I discuss financial preparedness with my family/household.
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True
False
FINANCIAL STABILITY - My Preparedness Score
Self Defense
How confident are you in your ability to stay calm and effective in a dangerous confrontation?
*
Not at all
Somewhat
Moderate
Mostly
Very
How aware are you of your surroundings in public places?
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Not at all
Somewhat
Moderate
Mostly
Very
How comfortable are you with the idea of defending yourself or loved ones?
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Not at all
Somewhat
Moderate
Mostly
Very
How consistent is your training/practice in self-defense skills?
*
Not at all
Somewhat
Moderate
Mostly
Very
How knowledgeable are you about legal/ethical considerations of self-defense in your area?
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Not at all
Somewhat
Moderate
Mostly
Very
I have training in a martial art (Muay Thai, Jiu-Jitsu, etc.).
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True
False
I train regularly (sparring, drills, scenario practice).
*
True
False
I own and train with defensive tools (pepper spray, firearm, etc.).
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True
False
I have firearms training and practice safe storage and handling.
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True
False
I know the laws regarding use of force in self-defense.
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True
False
I practice situational awareness techniques daily.
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True
False
I’ve trained under stress-inoculation or realistic scenario conditions.
*
True
False
I carry some form of self-defense tool when legal and appropriate.
*
True
False
I have a home defense plan, public escape plan (exists, barriers, etc.), and practice them regularly with my family.
*
True
False
SELF DEFENSE - My Preparedness Score
Emergency Communications
How confident are you that your family could contact each other in an emergency?
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Not at all
Somewhat
Moderate
Mostly
Very
How prepared are you to communicate if cell networks fail?
*
Not at all
Somewhat
Moderate
Mostly
Very
How aware are you of communication channels (radio, ham, satellite) beyond phones?
*
Not at all
Somewhat
Moderate
Mostly
Very
How consistent are you in practicing your communication plan?
*
Not at all
Somewhat
Moderate
Mostly
Very
How confident are you that your plan covers multiple scenarios (home, work, school)?
*
Not at all
Somewhat
Moderate
Mostly
Very
I have a written family communication plan.
*
True
False
My plan includes primary, alternate, contingency, and emergency methods (PACE).
*
True
False
I have backup power sources for communication devices.
*
True
False
I own and know how to use a handheld radio (FRS/GMRS/ham) and/or have access to satellite communication devices..
*
True
False
I know local emergency radio frequencies.
*
True
False
My family has pre-designated meeting points if communications fail.
*
True
False
I’ve practiced communication drills with my family.
*
True
False
I maintain updated emergency contacts (neighbors, out-of-town, local).
*
True
False
I’ve tested my communication equipment in real conditions.
*
True
False
EMERGENCY COMMS - My Preparedness Rating
Medical Response
How confident are you in your ability to treat injuries before professional help arrives?
*
Not at all
Somewhat
Moderate
Mostly
Very
How calm do you feel when facing medical emergencies?
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Not at all
Somewhat
Moderate
Mostly
Very
How often do you refresh your medical training?
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Not at all
Somewhat
Moderate
Mostly
Very
How comfortable are you using medical gear (tourniquets, splints, AEDs)?
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Not at all
Somewhat
Moderate
Mostly
Very
How aware are you of your household’s specific medical needs?
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Not at all
Somewhat
Moderate
Mostly
Very
I am trained in CPR and first aid.
*
True
False
I have trauma response training (bleeding control, airway management, shock).
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True
False
I own and maintain a stocked first aid/trauma kit AND I know how to use everything in my kit.
*
True
False
I keep necessary medications for myself and my family stocked for at least 30 days.
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True
False
I know basic wound care (cleaning, dressing, infection prevention).
*
True
False
I can stabilize a broken bone or sprain until professional care arrives.
*
True
False
I know how to recognize dehydration, hypothermia, or heat stroke.
*
True
False
I know how to safely transport an injured person if necessary.
*
True
False
I have practiced medical scenarios with family or group members.
*
True
False
MEDICAL RESPONSE - My Preparedness Score
Food, Water Storage & Homesteading
How confident are you that your household could eat well if grocery stores closed?
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Not at all
A few days
A few weeks
1-3 months
More than 3 months
How prepared do you feel to produce or preserve food?
*
Not at all
Somewhat
Moderate
Mostly
Very
How secure do you feel in your household’s water supply?
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Not at all
Somewhat
Moderate
Mostly
Very
How confident do you feel in rotating or using your stored food/water?
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Not at all
Somewhat
Moderate
Mostly
Very
How knowledgeable are you about food preservation techniques (canning, dehydrating, fermenting)?
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Not at all
Somewhat
Moderate
Mostly
Very
I have at least 30 days of food AND drinkable water stored.
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True
False
I know how to purify water from natural sources.
*
True
False
I grow some of my own food (garden, fruit trees, livestock, etc.).
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True
False
I know how to cook and prepare food without electricity or gas.
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True
False
I store long-term staple foods (rice, beans, wheat, etc.).
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True
False
I regularly rotate my food storage to prevent waste.
*
True
False
I have tools/supplies for food preservation.
*
True
False
I know the caloric and nutritional needs of my household.
*
True
False
I’ve tested living off my stored food/water for at least 1 week.
*
True
False
FOOD/WATER STORAGE - My Preparedness Score
TOTAL - My Comprehensive Preparedness Score
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