NPK Health Integration Questionnaire - First Steps
Whole Health for the Whole Woman. From Limited to Limitless.
Email
First Name
Date
Social Health
Where you are right now, on a scale of 1-5 (lowest to highest satisfaction).
Support system/sense of belonging
Fun activities
Fulfilling family/friend/work relationships
Caring and doing for others
Contributing to community
Communicating effectively
Emotional Health
Where you are right now, on a scale of 1-5 (lowest to highest satisfaction).
Experiencing your emotions
Acknowledging your emotions
Expressing your emotions
Showing compassion for others
Showing empathy for others
Mental Health
Where you are right now, on a scale of 1-5 (lowest to highest satisfaction).
Managing stress
Working productively/Career satisfaction
Realizing your potential
Fostering confidence
Achieving goals
Cultivating self-esteem
Physical Health
Where you are right now, on a scale of 1-5 (lowest to highest satisfaction).
Exercising
Sleeping
Nutrition
Satisfactory and regular healthcare
Physical environment (home/office/other)
Self-care practices
Intellectual Health
Where you are right now, on a scale of 1-5 (lowest to highest satisfaction).
Practicing curiosity
Managing frustration and working through it
Accepting failure and working through it
Learning/growth-mindset
Spiritual Health
Where you are right now, on a scale of 1-5 (lowest to highest satisfaction).
Experiencing a sense of purpose
Making time for reflection
Feeling hopeful and optimistic about the future
Practicing altruism
Belief in a higher power/something greater than you
I understand that my answers are confidential and will not be shared with a third party.
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