1. In general, how healthy are you?
• Extremely healthy
• Quite healthy
• You're about average - you have a few health problems
• You have a good deal of health issues
• Your health is so poor that it effects you every day
2. Do you feel successful?
• Definitely
• Pretty much, but there's still more to do
• You're starting to feel successful, but you have a lot more you need to achieve
• You've had a few successes, but you don't feel successful
• Not at all
3. How would you describe your social status?
• Upper class
• Upper middle class
• Middle class
• Lower middle class
• Lower class
4. How is your love life?
• Excellent
• Pretty good
• About average
• Not so great
• Totally horrible
5. During an average day, what percent of your activities are fun, enjoyable, meaningful, or rewarding?
• Almost 100%
• Over 75%
• Over 40%
• Over 10%
• 10% or less
6. Do you have enough friends and family support?
• Absolutely
• Pretty much
• Most of the time, but you could use more
• No - you're often lonely
• No - you don't have anyone to turn to
7. How would you describe your income / net worth?
• Very high
• Pretty high
• About average
• Low
• Below poverty level
8. You would describe your outlook as:
• Very optimistic
• Mostly optimistic
• Neither optimistic nor pessimistic
• Mostly pessimistic
• Very pessimistic
9. You feel like your life has a purpose:
• Every day
• Most days
• Some days
• Occasionally
• Hardly ever
10. Do you like yourself?
• Definitely
• Most of the time you do
• Yes, but there's a good deal you'd like to change
• Depends on the day
• No, not usually

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