Wheel of Life Survey

Please take some time to reflect on the level of fulfillment in your life in each of the categories below.  The outer edge of the Wheel of Life represents complete fulfillment, the center no fulfillment.  Rank your level of satisfaction in each life area by drawing a line in each section to create a new outer edge of the wheel.  The closer you are to the outer edge (a 10) the more fulfilled you are.  The new perimeter of the circle you draw represents your Wheel of Life.  How well does your wheel roll?

Once you have completed the form please connect with us through the Contact page so we can arrange transfer of the document.


  1. Physical – Do I maintain a desirable weight, engage in exercise and get plenty of sleep?  Am I sensitive to my body’s needs?  Do I take precautions when driving or participating in recreational activities?  Do I stay out of dangerous situations and unnecessary risks?
  2. Nutritional – Do I pay attention to the amount of calories I consume?  Do I eat high-fiber foods and plenty of fruit and vegetables?  Do I avoid eating foods that are not nutritional?  Do I drink plenty of water?
  3. Spiritual – Do I believe in a power greater than myself?  Do I reflect on what is truly important in life?  Do I live in a way that has a positive effect on others?  Am I grateful for what I have?  Am I tolerant of the beliefs of others?
  4. Emotional & Social – Do I have a good self-image?  Am I able to laugh at myself?  Do I recognize when I’m upset?  Am I able to express anger in a way that is not hurtful to others?  Am I able to develop deep, personal relationships?  Do I have the amount of friends that I want?  Do I have a support network?  Am I available to help others?
  5. Personal Development & Growth – Are there things in my life I would like to accomplish but just can’t seem to get started?  Do I seek opportunities to learn new things?  Do I respond to life’s challenges with sound thought and judgment?  Am I open to new ideas?  Do I manage my time well?  Am I growing as a human being?
  6. Occupational & Finance –Is my work meaningful and purposeful?  Do I enjoy my job?  Is my career consistent with my goals and values?  Do I have good relationships with coworkers?  Do I have healthy financial habits? Do I have and stick to a budget?  Do I have a six month “safety net”?  Do I have, contribute to and manage a retirement account?
  7. Recreational – Do I take time to relax and have fun?  Do I have ways to let go of the stress involved in daily life?  Are these “healthy” choices?
  8. Environmental – Do I feel connected with nature?  Do I reduce, recycle, reuse and renew resources?  Do I conserve water and energy?  Do I keep my home and work space free of clutter?

Click on the link below to open and print your wheel.


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Rate your physical fulfillment

Rate your nutritional fulfillment

Rate your spiritual fulfillment

Rate your emotional & social fulfillment

Rate your personal development & growth fulfillment

Rate your occupational & financial fulfillment

Rate your recreational fulfillment

Rate your environmental fulfillment