Family Pillar Questions
Question 1
I have meaningful conversations with my immediate family (spouse, children, siblings, parents, etc.) on regular (1-2x/week) basis
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 2
I spend adequate quality time with family
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 3
I have a healthy relationship with my extended family (grandparents, aunts/uncles, cousins, etc.)
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 4
I do not have unresolved conflict and unforgiveness between myself and family members
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Input Total Score from 4 Family Pillar Questions (20-100)
Friends Pillar Questions
Question 1
I have at least 3 close friends that I spend regular (1-3x/month EACH) quality time with
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 2
My friends challenge and inspire me to become a better person
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 3
I feel that when I need them I have friends available to talk to and help me. I also make myself available to talk with and help my friends when they need it.
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 4
I do not have unresolved conflict and unforgiveness between myself and my friends (or “former” friends)
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Input Total Score from 4 Friends Pillar Questions (20-100)
Leisure Pillar Questions
Question 1
I take a weekly day off from work to rest and enjoy leisure pursuits
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 2
I regularly (2-4x/year) schedule time off throughout the year for vacations and rest
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 3
I regularly (1-2x/week) engage in activities that get me outside, connect me with nature, and reduce my screen time
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 4
I have hobbies that I’m interested in and challenge/grow me (Netflix doesn’t count…)
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Input Total Score from 4 Leisure Pillar Questions (20-100)
Work Pillar Questions
Question 1
I feel challenged, engaged, and growing with my work
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 2
I feel appreciated, recognized and properly compensated for my work
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 3
I have a clear direction on where I want to go with my career and how to get there
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 4
I feel like I’m where I should be in my career for this stage of my life
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Input Total Score from 4 Work Pillar Questions (20-100)
Finance Pillar Questions
Question 1
I have a budget and follow it
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 2
I have short term (1-12 month), medium term (1-5 years), and long term (5+ years/retirement) saving and investing goals and am on track for those goals
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 3
I feel the money I earn and have saved is adequate for the goals I have in my life
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 4
I feel I have a manageably small amount of debt and a plan for paying off what I do have
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Input Total Score from 4 Finance Pillar Questions (20-100)
Health Pillar Questions
Question 1
I regularly engage in both strength training 3-4x/week and cardio training 3-4x/week
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 2
I regularly get good sleep (7-8 hours/night)
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 3
I feel I have a healthy body composition (low fat and good muscle), am flexible, and have no chronic aches, pains, or sickness
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 4
I eat a healthy balanced diet
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Input Total Score from 4 Health Pillar Questions (20-100)
Service Pillar Questions
Question 1
I have organizations (charities, church, etc.) that I volunteer with on a regular basis (1-2x/month)
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 2
When my friends or family need help I take time to help them
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 3
I feel I’m part of a healthy community
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 4
I financially give a healthy amount (5-10%+) of my income to causes that are important to me
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Input Total Score from 4 Service Pillar Questions (20-100)
Belief Pillar Questions
Question 1
I have a well-defined set of values that I believe to be absolutely true
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 2
When faced with a difficult situation or decision, I act based on principles and not circumstances
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 3
I believe that I’m part of a greater purpose and am connected with others in shared destiny
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Question 4
I acknowledge the existence of Higher Power and engage in regular meditation/prayer
Strongly Disagree (5pts) Disagree (10pts) Neutral (15pts) Agree (20pts) Strongly Agree (25pts)
Input Total Score from 4 Belief Pillar Questions (20-100)
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