To assure you receive the results of your survey, please double check the accuracy of your email address in the box below. Name: E-mail: Indicate how you're doing in each of the following key areas of your life by selecting a number from 1 through 5 below each statement. 1. Is your weight about right? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 2. Are you eating a healthy, balanced diet? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 3. Do you limit your use of drugs? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 4. Are you exercising vigorously 3 to 4 times a week? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 5. Are you keeping your body toned by stretching daily? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 6. Are you getting enough rest and sleep? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 7. Do you express love and caring easily and frequently? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 8. Are you finding time to maintain your friendships? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 9. Are you dealing honestly with conflicts as they arise? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 10. Do you have a satisfying sex life? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 11. Do you have at least one relationship where you feel totally accepted? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 12. Do you feel sustained by your relationships? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 13. Are you reading enough good books? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 14. Are you informed about and involved in larger social and world issues? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 15. Are you exposing yourself to stimulating, new ideas? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 16. Does your lifestyle reflect your basic values? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 17. Do you take time periodically to reflect on the purpose of your life? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 18. Are you finding meaning in your life as a whole? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 19. Are you engaged in satisfying work? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 20. Are you pleased with the activities that capture most of your time? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 21. Are you making the kind of contribution to others you want to? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 22. Are you making good use of your talents? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 23. Are you having fun and enjoying your fair share of belly laughs? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 24. Are you content with what you've achieved thus far? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 25. Are you starting most days with energy and confidence? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 26. Do you feel good about your options and prospects? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 27. Do you have a support system that assists you in achieving your goals? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 28. Are you living mostly in the present as opposed to the past and future? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 29. Are you in control of your use of time? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great 30. Are you coping well with the inevitable losses that come to all of us? 1 2 3 4 5 Ashamed To Say Need Major Tuneup Need Modest Change Need Fine Tuning Doing Great Note: Please wait a moment after clicking on "submit" to be sure your responses were transmitted. All items must be completed in order to have a successful transmission.