0% Created on October 03, 2022 By wjdevelopmental Good Self-Care Assessment Rate each statement with one of the following: 1 – Rarely 2 – Sometimes 3 – Frequently Good Self-Care Assessment Log-in Form NameEmail Review your responses and consider the following for each statement. 1 – Rarely Needs improvement - let’s talk about how to strengthen this area. 2 – Sometimes Good job! We can come up with ideas to help you be more consistent. 3 – Frequently Great job! Keep up the good work! 1 / 10 I get plenty of rest and sleep 7-8 hours daily 1 – Rarely 2 – Sometimes 3 – Frequently Review your responses and consider the following for each statement. 1 – Rarely Needs improvement - let’s talk about how to strengthen this area. 2 – Sometimes Good job! We can come up with ideas to help you be more consistent. 3 – Frequently Great job! Keep up the good work 2 / 10 I eat healthy foods and regular meals 1 – Rarely 2 - Sometimes 3 – Frequently Review your responses and consider the following for each statement. 1 – Rarely Needs improvement - let’s talk about how to strengthen this area. 2 – Sometimes Good job! We can come up with ideas to help you be more consistent. 3 – Frequently Great job! Keep up the good work! 3 / 10 I maintain contact with people who support me emotionally 1 – Rarely 2- Sometimes 3- Frequently Scoring: Review your responses and consider the following for each statement. 1 – Rarely Needs improvement - let’s talk about how to strengthen this area. 2 – Sometimes Good job! We can come up with ideas to help you be more consistent. 3 – Frequently Great job! Keep up the good work! 4 / 10 I exercise 30 minutes or more 3-5 times per week. 1 – Rarely 2 – Sometimes 3 – Frequently Review your responses and consider the following for each statement. 1 – Rarely Needs improvement - let’s talk about how to strengthen this area. 2 – Sometimes Good job! We can come up with ideas to help you be more consistent. 3 – Frequently Great job! Keep up the good work! 5 / 10 I take a break at work every 1 – 1.5 hours to stretch and move around. 1 – Rarely 2 – Sometimes 3 – Frequently Review your responses and consider the following for each statement. 1 – Rarely Needs improvement - let’s talk about how to strengthen this area. 2 – Sometimes Good job! We can come up with ideas to help you be more consistent. 3 – Frequently Great job! Keep up the good work! 6 / 10 I engage in spiritual activities regularly 1 – Rarely 2 – Sometimes 3 – Frequently Review your responses and consider the following for each statement. 1 – Rarely Needs improvement - let’s talk about how to strengthen this area. 2 – Sometimes Good job! We can come up with ideas to help you be more consistent. 3 – Frequently Great job! Keep up the good work! 7 / 10 I play! I do something fun at least once a week. 1 – Rarely 2 – Sometimes 3 – Frequently Review your responses and consider the following for each statement. 1 – Rarely Needs improvement - let’s talk about how to strengthen this area. 2 – Sometimes Good job! We can come up with ideas to help you be more consistent. 3 – Frequently Great job! Keep up the good work! 8 / 10 I nurture my relationships – call/write/email/visit/talk/date. 1 – Rarely 2 – Sometimes 3 – Frequently 9 / 10 I get outside daily – the fresh air and lush greenery are good for me! 1 – Rarely 2 – Sometimes 3 – Frequently Review your responses and consider the following for each statement. 1 – Rarely Needs improvement - let’s talk about how to strengthen this area. 2 – Sometimes Good job! We can come up with ideas to help you be more consistent. 3 – Frequently Great job! Keep up the good work! 10 / 10 I use my down time to rejuvenate – do something I enjoy. 1 – Rarely 2 – Sometimes 3 – Frequently Your score is 0%
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