Mildlycanletgo

RaymondWSmith,LMT810EMainStreetRichmond,MO64085888-425-3046Page1of4HolisticHealthandWellnessSurveyv1.
0,2008RaymondWSmithLMT,AdaptedfromaquestionnairedevelopedbyVickyCervantes.
Providedinformationwillbekeptcondential.
hBody:PhysicalandEnvironmentalHealth1)Imaintainahealthydiet(notrans-fats,lowsugar,freshproduce,andwholegrains).
2)Mywaterintakeisadequateformybody(atleast1/2oz/lbofbodyweight;160lbs=80oz).
3)Iamwithin20%ofmyhealthy,idealbodyweight.
4)IfeelthatIamphysicallyattractive.
5)Ifallasleepeasilyandsleepsoundly.
6)WhenIawakeinthemorning,Ifeelwell-rested.
7)Ihavemorethanenoughenergytomeetallofmydailyresponsibilities.
8)Myvesensesareacute.
9)Itaketimetoexperiencethesensualpleasuresinlife.
10)Ischeduleregularmassagesordeep-tissuebodywork.
11)Mysexualrelationshipfeelsgratifying.
12)Howoftendoyouengageinregularphysicalworkouts(lastingatleast20minutes)13)IfeelthatIhavegoodenduranceoraerobiccapacity.
14)Howfrequentlydoyoubreathabdominallyforatleastseveralminutes15)Imaintainphysicallychallenginggoalsinmylife.
16)Iamphysicallystrong.
17)Howfrequentlydoyouparticipateinstretchingexercises18)Iamfreeofchronicaches,pains,ailments,anddiseases.
19)Howregularlydoyouhaveeffortless,painlessbowelmovements20)Iunderstandthecausesofmychronicphysicalproblems.
21)Iamfreeofanydrug(includingcaffeine,nicotine,andalcohol)dependency.
22)Iliveandworkinahealthyenvironmentwithcleanair,water,andlow/noindoorpollution.
23)Ifeelenergizedandempoweredbynature.
24)Ihaveastrongconnectionwithandappreciationformybody,home,andenvironment.
25)Ihaveanawarenessoflife-energy,orqi.
TotalBodyScoreHolisticHealthandWellnessSurveyName:Date:Answerthequestionsineachsectionbelow.
Eachresponsewillbeanumberfrom0to5,andwillcorre-spondtoeitherhowstronglyyouagreewiththestatementor,ifthequestionisrelatedtoanactivity,thefrequencydescribedintheparentheses.
Followingeachsection,totalyourscoreandcompareyourresultstothedescriptionsgivenattheendofthesurvey.
0=Stronglydisagree(onceayearorless)1=Disagree(2to12times/year)2=Mildlydisagree(2to4times/month)3=Mildlyagree(2to3times/week)4=Agree(4to6times/week)5=StronglyAgree(daily)RaymondWSmith,LMT810EMainStreetRichmond,MO64085888-425-3046Page2of4HolisticHealthandWellnessSurveyv1.
0,2008RaymondWSmithLMT,AdaptedfromaquestionnairedevelopedbyVickyCervantes.
Providedinformationwillbekeptcondential.
hMind:MentalandEmotionalHealth1)Ihavespecicgoalsinmypersonalandprofessionallife.
2)Ihavetheabilitytoconcentrateforextendedperiodsoftime.
3)Iusevisualizationtohelpmeattainmygoalsandenhancemyperformance.
4)Ibelievethatitispossibletochange.
5)Ihavenoproblemmeetingmynancialneedsanddesires.
6)Myoutlookonlifeisbasicallyoptimistic.
7)Imakeitahabittogivemyselfmoresupportivemessagesthancriticalmessages.
8)Myjobutilizesallofmygreatesttalents.
9)Indmyjobenjoyableandfullling.
10)Iamwillingtotakerisksormakemistakesinordertosucceed.
11)Iamabletoadjustmybeliefsandattitudesasaresultoflearningfrompainfulexperiences.
12)Ihaveagoodsenseofhumor.
13)Imaintainpeaceofmindandtranquility.
14)Iamfreefromastrongneedforcontrolortheneedtoberight.
15)Iamfullyabletoexperience(feel)awiderangeoffeelingssuchasjoy,excitement,happi-ness,peacefulness,fear,anger,sadness,andhopelessness.
16)Iamawareofandabletosafelyexpressfear.
17)Iamawareofandabletosafelyexpressanger.
18)Iamawareofandabletosafelyexpresssadnessorcry.
19)Iamacceptingofallofmyfeelings,bothpositiveandnegative.
20)Howfrequentlydoyouengageinmeditation,contemplation.
21)Mysleepisfreefromdisturbingdreams.
22)Howregularlydoyouexplorethesymbolismandemotioncontentofyourdreams23)Howoftendoyoutakethetimetorelax,ormaketimeforactivitiesthatyoundfunThisdoesnotincludetimespentonacomputerorwatchingtelevision.
24)Howfrequentlydoyouexperiencefeelingsofexhilaration25)Ihaveahighlevelofself-esteemandself-respect.
TotalMindScore0=Stronglydisagree(onceayearorless)1=Disagree(2to12times/year)2=Mildlydisagree(2to4times/month)3=Mildlyagree(2to3times/week)4=Agree(4to6times/week)5=StronglyAgree(daily)RaymondWSmith,LMT810EMainStreetRichmond,MO64085888-425-3046Page3of4HolisticHealthandWellnessSurveyv1.
0,2008RaymondWSmithLMT,AdaptedfromaquestionnairedevelopedbyVickyCervantes.
Providedinformationwillbekeptcondential.
hSpirit:SpiritualandSocialHealth1)Iactivelycommittimetomyspirituallifeanddevelopment.
2)Howroutinelydoyoutaketimeforprayer,meditation,orreection3)Ilistenandactonmyintuition.
4)Iregularlyincorporatecreativeactivitiesintomyworkandleisuretime.
5)Iliketotakerisksorexceedmypreviouslimits.
6)Ihaveafaithinagod,spiritguides,universalspirit,orangels.
7)Iamfreefromangertowardspirituality.
8)Howfrequentlydoyoumakeaconsciouseffortofbeinggratefulfortheblessingsinyourlife9)Howoftendoyoutakewalks,garden,orhavecontactwithnature10)Iamabletoletgoofmyattachmenttospecicoutcomesandembraceuncertainty.
11)Iobserveadayofrestcompletelyawayfromwork,dedicatedtonurturingmyselfandmyfamily.
12)Icanletgoofself-interestindecidingthebestcourseofactionforagivensituation.
13)Ifeelastrongsenseofpurposeinmylife.
14)Imaketimetoconnectwithyoungchildren,eithermyownorsomeoneelse's.
15)Playfulnessandhumorareimportantinmydailylife.
16)Ihavetheabilitytoforgivemyselfandothers.
17)Ihavedemonstratedthewillingnesstocommittoamarriageorcomparablelong-termrela-tionship.
18)Iexperienceintimacy,besidessex,inmycommittedrelationship.
19)Iamabletocondein,orspeakopenlywith,oneormoreclosefriends.
20)Idoordidfeelclosetomyparents.
21)Ihavebeenabletofullygrievethelossofanylovedonesinmylife.
22)Myexperiencewithpainhasenabledmetogrowspiritually.
23)Howoftendoyougooutofyourwayorgiveyourtimetohelpothers.
24)Ifeelasenseofbelongingtoagrouporcommunity.
25)Iexperienceunconditionallove.
TotalSpiritScore0=Stronglydisagree(onceayearorless)1=Disagree(2to12times/year)2=Mildlydisagree(2to4times/month)3=Mildlyagree(2to3times/week)4=Agree(4to6times/week)5=StronglyAgree(daily)RaymondWSmith,LMT810EMainStreetRichmond,MO64085888-425-3046Page4of4HolisticHealthandWellnessSurveyv1.
0,2008RaymondWSmithLMT,AdaptedfromaquestionnairedevelopedbyVickyCervantes.
Providedinformationwillbekeptcondential.
hYourTotalScoreBodyScoreMindScoreSpiritScoreYourTotalHolisticHealth&WellnessScore(325-375)OptimalCongratulations!
Youhavebeentakingcareofyourself,andmostlikelyhavearmunderstandingoftherelationshipbetweenyourhealthandyourmind,body,spirit,andemotions.
Continuetolearndeepertruthsaboutyourselfandad-dressyourchangingneedsasyouevolveinlifetomaintainyouroptimalheath.
Asanindividualwithsuchpositivehabitsandpractices,youareashiningexampleofhowtoliveagreatlife.
Spreadyourknowledgeandkeepupthegoodwork!
(275-324)ExcellentYouhavebeenworkinghardtodevelopagreaterunderstandingofyourself,anditshows.
Byactivelyparticipatinginyourownhealth,youhavecreatedpositivepatternsinyourlifeandhaveleftdestructiveoldhabitsinthepast.
Asyoucontinuetondandcorrectthehiddensourcesofyourproblems,youwillndadeeperjoyineverydaylivingandseemorebenetsinhowyoufeel.
(225-274)GoodYouhaveprobablystartedfeelingtheconnectionbetweenyourbody,mind,spirit,andemotions,andcansensewhenthingsaregoingwrong.
Continuetomakechangesinyourlifethatreecttakinganactiveroleincreatingyourownhealth.
Asproblemscomeup,usethemasopportunitiestodiscovermoreabouthowyoufunctionandndpositivewaystocorrectthem.
Connectwithothersthathavesimilarviewsandgoalsofoptimalhealthasyoubuildupyoursupportnetwork.
Avoidstartinganybadorunhealthyhabits,asyouhavealreadyworkedhardtogetthishealthy!
(175-224)FairWhenitcomestoyouroverallhealth,thereareafewthingsmissing.
Startcultivatingastrongerconnectionbetweenyourbody,mind,spirit,andemotionstoencouragebetterhealthandwellness.
Lookinwardtondhiddenbeliefsandbehav-iorsthatarepreventingyoufromachievingoptimalhealth.
Nowisalsothetimetobeginlearningpositivewaysofcor-rectinganynegativebehaviorsandcreatingmorebalanceinyourlife.
Byworkingtoestablishastrongfoundationnow,youwillsoonbeabletobuildanourishinglifestyleforyourfuture.
(125-174)BelowAverageThingsmaynottoobadatthistime,butyouareheadingdownadangerousroad.
Ifyouhaven'talready,startmakingchangesinyourlifethatwillstrengthenyourbody,mind,spirit,andemotions.
Lookforothersthathavesimilargoalsofoptimalhealthandestablishagoodsupportnetwork.
Continuendingpositiveactionstoreplaceunhealthyornegativehabits,andpracticethemdaily.
Beforelongyouwillbefeelingandlookinggreat!
(75-124)PoorThisisdenitelythetimetostartmakingchangesbeforethingsgetanymoredifcult.
Takingchargeandputtingyourhealthrstisveryimportantforyourightnow.
Knowledgeispower,sothisisagreattimetostartlearninghealthynewhabitsandusethemtoreplacethenegativethingsinyourlife.
Shareyournewthoughtsandaspirationswithothers,andestablishasupportnetwork.
Focusonyourgoalofoptimalhealth,andmakedecisionsthatreectthatgoal.
Remembertokeepaskingforhelpifyouneedit!
(0-75)ExtremelyUnhealthySomethingneedstochange,andfast!
Iftheunhealthypatternsinyourlifearenotalreadycreatingillness,theysoonwill.
Itisvitalthatyoutakecontrolofthesituationandmakeseveralpositivechangesinhowyouareliving.
Startlearningnewwaystoworkhealthyhabitsintoyourlifeanddothemdaily!
Makingimprovementsismucheasierwithsupport,sotalkwithothersaboutwhatyouaredoing.
Iftherearepeopleinyourlifedonotsupportthesechanges,ndmorewhowill.
Don'tbeafraidtoaskforhelpifyouarestrugglingorfeelyouneedit.
Maintainingapositiveoutlookisextremelyimportant,sostartkeepingtrackofthethingsyouaregratefulforinlife.
Thingscanonlygoupfromhere!
YourScoreAnalysis