Work Life Balance Survey
Complete this 5 minute survey by copying, pasting and sending to allison@brightlifecoacing.com.au and receive
20% off
a work life balance consultation. Would it be of value to you to maintain your income, reduce stress and increase your time doing the things you love?
1) Approximately how many hours do you work a week?
______________________________
2) How satisfied are you with this amount? (On a scale of 1 to 10. 1 being the least satisfied and 10 being the most satisfied)
______________________________
3) Is this amount of work hours comfortable for you to maintain over a long period of time?
_________________________
4) Approximately how many hours do you spend with family per week?____________________
5) Approximately how many hours do you spend nurturing yourself per week? eg hot baths, hobbies.__________________
6) How satisfied are you with your health? (On a scale of 1-10. 1 being the least satisfied and 10 being the most satisfied.)
__________________________
7) How effectively do you use your time at work? (On a scale of 1-10. 1 being least effective and 10 being most effective.)
__________________________
8) How effectively do you use your time at home? (On a scale of 1-10. 1 being least effective and 10 being most effective.)
___________________________
9) How much work is planned for your day?
Too little…………………………………………………just right……………………………………………………too much
10) Boundaries are limits we set which enable us to meet our needs.
How do you rate your ability to set boundaries to meet your needs? (On a scale of 1-10. 1 being you can never say ‘no’. 10 being you have strong flexible boundaries that serve you well.)
At work.____________________________ AT home______________________________
11) What are three greatest challenges that prevent your ideal work life balance?
12) What are three limiting beliefs that prevent you from having your ideal work life balance?
13) When the end of your time has come what will you regret the most?
Thankyou for completing this survey by emailing your answers in the contact box below . This information is kept confidential and will be beneficial to the work done in supporting people to maintain a healthy balance with work and life.
