This survey was designed to help identify whether your busy lifestyle or other stressors are keeping you from connecting to your authentic self, finding and keeping that connection to your inner wisdom and peace. You will get an immediate score and many easy strategies and suggestions to support you in feeling less overwhelmed, more relaxed, happier and healthier while creating more balance in your life.

1. I frequently wake up in the night worrying.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
2. I often worry about my safety or my family's safety.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
3. I hold a grudge.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
4. I lose my temper easily.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
5. I find myself getting angry with other drivers.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
6. I feel overwhelmed.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
7. I feel disorganized.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
8. When I am under pressure I take or drink something to calm down ( headache relievers, antacids, or a glass of wine or beer)
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
9. I frequently have an upset stomach, backache or a headache.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
10. I feel in control of my life.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
11. I am not assertive when I need to be.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
12. When I am down and need someone to talk to I don't have friends or family that support me positively.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
13. I usually resist change.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
14. I exercise inconsistently or not at all.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
15. I can't find time even 15 minutes a day for myself.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree
16. I do not feel connected spiritually or feel my life has a purpose and meaning.
	Strongly disagree Moderately disagree Moderatly agree Strongly agree