360 Assessment

Physical

• My weight is within national standards.
• I exercise on a regular basis.
• I drink plenty of water each day.
• I eat only when I am hungry.
• I have a well-balanced diet.
• I get between seven and eight hours of sleep a night.
• I find healthy means to deal with my stress. Exercise, etc.
• My clothes fit comfortably.
• I place a high value on my person hygiene.
• I treat myself to personal attention at least once a month. Hair, nails, etc.
• I enjoy extra curricular activities
• I am well groomed when out in public.
• I know how many calories I eat a day.
• I am happy with my hairstyle.
• I do nor smoke or use illegal drugs
• I have had a complete physical within the past two years.
• I floss on a regular basis
• I use my vacation time to vacation.
• My blood pressure is healthy
• My cholesterol count is healthy.
• My teeth and gums are healthy.
• I rarely watch television.
• I monitor my caffeine.
• I watch my sugar consumption.
• I use sunscreen.

Total  _____________

Emotional

• I surround myself with positive influences.
• I have a good relationship with my family members.
• I have set three personal standards I live by.
• I have dealt with issues from my past.
• I am consistently early or on time for appointments
• I do not have clutter sitting around my house.
• I have a clear conscience with my colleagues.
• I don’t look to others for my personal well-being.
• I know and articulate my personal value.
• I choose my friends based on interest not need.
• I have a steady emotional gauge.
• I keep my stress level within a healthy balance.
• I follow through with what I commit to do.
• I am comfortable in expressing my emotions.
• I have told my family I love them in the last three days.
• I address feelings of anger and resentment immediately when felt.
• I love and value myself.
• I do not allow unhealthy thoughts to linger in my mind.
• I sleep easy at night knowing my conscience is clear.
• I do not have any one in my life that emotionally drains me.
• I trust my spouse/ friends to be honest with me.
• I do not worry.
• I do not run on adrenaline to get the job complete.
• I practice times of silence and meditation.
• I have a fulfilling life.

Total  __________

Spiritual

• I feel closer to God today than I did last year.
• I think of God on a daily basis.
• I read the Bible when I am looking for answers and guidance.
• I feel God loves me.
• I am at ease talking to my friends and family about spiritual things.
• I trust God with my prayers.
• I believe God is interested in answering my prayers.
• I pray as God leads me to.
• I have a clear conscience before God.
• I attend church on a regular basis.
• I participate in service to the church or community
• I believe there is a place called heaven and feel comfortable with that fact.
• I give to my church and those in need.
• I read healthy spiritual material.
• I am comfortable talking about God.
• I memorize scripture and sacred writings.
• I have Christian friends I socialize with.
• I have an accountability partner, or mentor.
• I have been spiritually mentored.
• I am comfortable inviting someone to my church.
• I am currently praying about a matter.
• I have a healthy view of God.
• I am aware of certain temptations in my life and guard against them.
• I trust God more than I fear evil.
• I believe others see God through my life. 

Total   ______________