Wellness Inventory

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Wellness Inventory

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The Head Injury Hotline Wellness Inventory is a checklist of indicators of health, and well being. It was designed to to help you track, and measure indicators of your health and well-being. It also looks at your lifestyle and your style of problem solving. Briefly stated, it asks you to score your sense of your state of health, happiness, and prosperity.

Indicators of health and well being have to do with how healthy you feel, and how well you were able to meet your daily obligations. Other indicators have to do with how you handled any problems you might have encountered. Still others look at how you perceive yourself, and how you interact with others.

This Wellness Inventory can increase your self awareness and help you to identify patterns, or characteristics you might want to change. Designed for daily use it can help you track patterns, or behavior that might signal the presence of serious problems. Warning: A high number of "Hardly" or "None" answers on this inventory could indicate the presence of serious physical and or mental health conditions and should be immediately brought to the attention of a qualified physician, therapist or other appropriate professional.

Wellness Inventory

Instructions: Below is list of health and wellness indicators that describe how people feel and behave. The regular use of this inventory will increase your self-awareness. Additionally, it will provide a record for you to track such indicators in yourself.

day _____________ date ______________


	Rate how much these indicators described you today	Very	Moderately	Hardly	None
1.	How oriented, clear headed, did you feel today?
2.	How rested did you feel when you woke up this morning?
3.	How energetic, ready to go did you feel today?				.
4.	How strong did you feel today?
5.	Were you able to get around well enough today?
6	Were you able to meet challenges in your life today?
7.	How much were you able to meet your financial obligations today?
8.	How happy did you feel today?
9.	How much were you able to put things in perspective?
1O.	How much were you able to maintain your sense of humor today?
11.	How often did you lose it today, rage attacks, explosive outbursts?
12.	How much of an interesting person to be with were you today?
13.	How stressful was your day?
14.	How much were you able to manage stresses in your life today?
15.	How stressful was your work day?
16.	How much were you able to fulfill your work responsibilities today?
17.	How well did you get along with your co-workers or clients today?
18.	How much did you enjoy your family life today?
19.	How rewarding today was your family life?
20.	How much were you able to fulfill your family responsibilities today?
21.	How well did you get along with your friend(s) today?
22.	How much were you able to meet your social obligations today?
23.	How much did you enjoy your social or cultural activities today?
24.	How much time did you take for yourself today?
25.	How confident did you feel today?
26.	Did you feel good about your body today?
27.	Did your body do what you wanted today?
28.	How much were you able to stay on task today?
29.	How much did you feel that you could trust your instincts today?
30.	How much did you feel that you could trust your senses today?
31.	Did you have any bothersome health symptoms today?
32.	Did you feel susceptible to illness?

33.	What was most stressful to you today?
34.	What did you do about it?
35.	Did your action make it better, worse, or no difference?
36.	What was the most restful to you today?
37.	What did you do about it?
38.	How much time did you take for yourself today?
39	How did it make your day better or worse?
40.	What did you have to celebrate to day?
41.	What did you do about it?
42.	Did your action make it better, worse, or no difference?
43.	For what did you have to be thankful today?
44.	Did you remember to give thanks?
45.	Did you have any trouble with your appetite today?
46.	How many meals did you eat today?
47.	Was that normal for you?
48.	Were the meals well balanced?
49.	How often did you snack today?
50.	Were they healthy snacks?
51.	How much water did you drink today?
52.	How many servings of caffeine drinks did you have today? (1 serving = 6-8 oz. coffee or tea; 8 -12 oz. soda)
53.	How many servings of alcohol did you drink today? (1 serving = 1-11/2 oz. liquor; 3-4 oz. wine; 8-12 oz. beer)
54.	Did you take any medication or drugs to day?
55.	Did you consult a health or mental health practioner today?
56.	Did you have sexual intercourse today? Yes __ No __

How many (total) minutes of each type of activity did you have today?

41.	Type of activity Minutes Type of activity Minutes
	Swimming	Running _____	Jogging _____	Walking _____
	Racquet sport	Biking _____	Dancing _____	Other, _________
	Stretching _____			Conditioning _____

42.

How did your physical activity change today compared with yesterday?

increased activity ................	cut down activity ..........	no change in activity .........
stayed in bed ...................	stayed home and inside ..........	other ..........................

43.

I went to sleep at ______ am/pm;

I woke up at ________ am/pm. (Last time woke up )

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