TS_Fall_2017

Take Care
Audre Lorde once wrote, “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.” Whether you need to recharge or relax, taking time out for yourself and practicing self-care are essential to staying healthy. Tu Salud wants to know whether you practice self-care in your life.
1) Do you believe it is important to practice self-care?

YesNo
2) How often do you set aside time for self-care?

DailySeveral times a weekOnce a weekLess than once a weekNever
3) Are you able to take time out for yourself without feeling guilty?

AlwaysSometimesNever
4) Do you recognize the difference between self-care and self-indulgence?

YesNo
5) Do you have a small group of people you can call on for support?

YesNo
6) Are you able to ask for help when you need it?

YesNo
7) Do you have relationships with people who make you feel good about yourself?

YesNo
8) Do you practice any stress reduction techniques, such as deep breathing or meditation?

YesNo
9) Do you get an adequate amount of sleep each night?

YesNo
10) Do you maintain good eating habits?

YesNo
11) Do you exercise regularly?

YesNo
12) In what specific ways do you practice self-care?

0/100
13) What year were you born?
14) What is your gender?

MaleFemaleTransgenderOther
15) What is your sexual orientation?

StraightGay/LesbianBisexualOther
16) What is your ethnicity? (Check all that apply.)

American Indian or Alaska NativeArab or Middle EasternAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or other Pacific IslanderWhiteOther
17) What is your household income?

Less than $15,000$15,000 to $34,999$35,000 to $49,999$50,000 to $74,999$75,000 to $99,999$100,000 or more
18) What is your zip code?
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Take Care