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Use the icons in the upper right corner to print this page. Instructions 1. Check the box if the statement is consistently true for you. 2. If the statement doesn't apply to you, please change it so that it does, or replace it with a different one that fits within that category. 3. Add up your section and total scores. 4. Check back every 30 or 90 days and you will likely see progress, even if you aren’t focusing directly on this program. 5. Work with a coach to help you get through the challenging items.
Family & Relationships 1. I am both pleased and content with my spouse/partner, or happy being single. 2. I am close to my parent(s), alive or not. There is nothing in the way; nothing between us. 3. I have a circle of friends who I truly enjoy, without any effort. 4. I have a best friend and treat him/her extremely well. 5. I am very close to my children. There is nothing in the way. 6. I enjoy my family/extended family; we have worked through any dysfunction and past problems. 7. I am part of a professional network that stimulates me intellectually and emotionally. 8. I get along well with my neighbors. 9. I have at least 20 friends and colleagues who live outside of my country of residence. 10. I am loved by the people who mean the most to me.
___ Section score (Number of checked boxes)
Career & Business 11. My work/career is both fulfilling and nourishing to me; I am not drained. 12. I am highly regarded for my expertise by my manager, clients and/or colleagues. 13. I am on a positive career path that leads to increased opportunities and raises. 14. I work in the right industry or field; it has a bright future. 15. I look forward to going to work virtually every day. 16. My work is not my life, but it is a rich part of my life. 17. I work with the right people. 18. My work environment brings out the very best of me because it is wonderfully stimulating and/or very supportive. 19. At the end of the day, I have as much energy as I did when I started the day; I am not drained. 20. The work I do helps to meet my intellectual, social and/or emotional needs.
___ Section score (Number of checked boxes)
Money & Finances 21. I have at least a year's living expenses in the bank or money market fund. 22. I am on a financial independence track or am already there. 23. I don't have to work at financial success; money seems to find me with very little effort or pushing. 24. I have no financial stress of any kind in my life. 25. I invest at least 10% of my income/earnings in my ability to increase/expand that income. 26. I do not carry credit card debt; I do not overspend. 27. When I buy something, I buy the best possible quality. 28. I don't lose sleep over my investments. 29. I am financially knowledgeable -- I know how money is made and lost. 30. I make money because I provide more than enough value to the people/customers who need what I have.
___ Section score (Number of checked boxes)
Joy and Delight 31. I spend my leisure time totally enjoying my interests; I am never bored. 32. Weekends (or other days off) are a joy for me. 33. I have designed the perfect way to spend the last hour of my day. 34. I look forward to getting up virtually every morning. 35. I am very, very happy. 36. I have designed -- and am living -- the perfect lifestyle for me right now. 37. I have at least an hour a day that is exclusively for me and I spend it in a chosen way. 38. I am able to stay present during the day; I don't lose myself to stress or adrenaline. 39. I easily take delight in the smallest things. 40. My home brings me joy every time I walk inside.
___ Section score (Number of checked boxes)
Effectiveness & Efficiency 41. I don't spend time with anyone who bugs me or who is using me. 42. I have more than enough energy and vitality to get me through the day; I don't start dragging. 43. I have no problem asking for exactly what I want, from anyone. 44. I have all of the right tools, equipment, computers, software and peripherals that I need to work well. 45. Whatever can be automated, is automated. 46. Whatever can be delegated, is delegated. 47. I reply to all emails as I read them; I don't maintain an inventory of unanswered emails. 48. I don't put things off; when it occurs to me, I do it, handle it, or have it done. 49. I know what my goals are and I am eagerly and effectively making them a reality. 50. I don't do errands, except by exception.
___ Section score (Number of checked boxes)
Responsibility & Foundation 51. I love my home: Its location, style, furnishings, light, feeling. 52. My boundaries are strong enough that people respect me, my needs and what I want. 53. I tolerate very, very little; I'm just not willing to. 54. I don't see a cloud on my future's horizon; it looks clear. 55. My wants have been satisfied; there is little I want. 56. My personal needs have been satisfied; I am not driven or motivated by unmet needs. 57. There is nothing I am dreading or avoiding. 58. My personal values are clear; I am oriented around them. 59. I have resolved the stresses and key issues of my upbringing and past events. 60. I don't have a lot of unfinished projects, business or hanging items; I am caught up.
___ Section score (Number of checked boxes)
Personal Development & Evolution 61. I could die this afternoon with no regrets. 62. I am living my life, not the life that someone else designed for me or expected of me. 63. There is nothing that I am not facing head-on; nothing that I am putting off dealing with. 64. I attract success; I don't have to strive for it or chase it. 65. I have more than enough natural motivation, inspiration and synergy in my life; I am not stuck. 66. I am evolving, not just improving, because I continually experiment. 67. I have progressed beyond the notion of beliefs. 68. I am at that place in life where I initiate and cause events, not wait for others or events to do so. 69. I have learned to take the path of least resistance as I accomplish my goals. 70. I am beyond striving for success; I simply enjoy my life and focus on what fulfills me.
___ Section score (Number of checked boxes)
Self-Care & Vitality 71. I take at least 4 vacations a year. 72. Life is easy; I have virtually no problems or unresolved matters affecting me. 73. My teeth and gums look great and are in top condition. 74. I have more than enough time during my day. 75. I eat food for sustenance and pleasure, not for emotional comfort. 76. I am not abusing my body with too much alcohol, television, caffeine or drugs. 77. Whatever health problems I have, I am receiving proper, effective care for them. 78. My body is in great shape. 79. I reduce stress daily by meditating, taking a long bath, exercising, walking, etc. 80. There is nothing I am doing that is messing up my mind or heart
___ Section score (Number of checked boxes)
Happiness & Contentment Please write down 10 situations, routines or scenarios that make, or would make, you the happiest and most content. 81. _________________________________________________ 82. _________________________________________________ 83. _________________________________________________ 84. _________________________________________________ 85. _________________________________________________ 86. _________________________________________________ 87. _________________________________________________ 88. _________________________________________________ 89. _________________________________________________ 90. _________________________________________________
___ Section score (Number of checked boxes)
Pleasure & Excitement Please write down 10 activities that you truly enjoy, whether you currently do these things in your life or not. 91. _________________________________________________ 92. _________________________________________________ 93. _________________________________________________ 94. _________________________________________________ 95. _________________________________________________ 96. _________________________________________________ 97. _________________________________________________ 98. _________________________________________________ 99. _________________________________________________ 100. ________________________________________________
___ Section score (Number of checked boxes)
___ Total score (Number of checked boxes)
Scoring Key: 90-100 Awesome. Congratulations. Incredible. 80-89 Excellent! Your score is very high -- this is a tough test. 70-79 Very good. You're definitely on track. Keep going. 60-69 Pretty good, but there is some work to do. 50-59 Average score. Why not make your quality of life a priority and score 10 more points in the next month? 40-49 You may need to make some important changes. 30-39 Weak. What's up with this? Make yourself a priority! 00-29 Hello? Anybody home?
v1.1 ©2000 by Thomas J. Leonard. Duplication, with attribution, permitted and encouraged.
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