Life Balance Approach:
Be Balanced!

Simply Health’s Life Balance Approach takes into account that each area of our lives affects how we feel about ourselves. In order to “Be Empowered,” we have to learn how to keep each dimension of our lives balanced. It is essential to understand that when one of our circles (Physical Environment, Nutrition, Interpersonal Relationships, Physical Movement, Mind-Body Connection, or Personal Growth and Development) is affected the other circles need to activate to keep your life in balance.

Coaching Client Profile

Please take time to complete the information and respond to the questions on the following pages. Some of the questions capture information about where you are today. Others will get you thinking about what you want from coaching as it pertains to all the dimensions in your life. This information will set a good foundation and allow you to choose a focus for your coaching experience to Be Empowered!

Note that all personal information is confidential.

Preferred way for me to contact you:

In each of the next numbered sections rate on a scale of 1 t0 10 your level of satisfaction with this dimension of your life:


1. Personal Growth and Development


Rating:

Describe the work you do and your level of satisfaction with it:

If you are retired or between jobs, how do you fill your days?

What do you want me to know about your education (e.g., levels completed, aspirations for continuing your education)?


2. Physical Environment


Rating:

Tell me about where you live, who you live with and if you are satisfied with your living environment?


3. Nutrition


Rating:

Give me a day in the life of your food consumption:

Do you generally feel satisfied with your food intake? Do you feel that you can improve this area of your life?


4. Interpersonal Relationships


Rating:

Are you in a committed relationship?

Do you feel satisfied with your friendships?

Do you have good friends at work or at school?


5. Physical Movement


Rating:

Tell me about your physical activity on a weekly basis?

What type of exercise do you enjoy doing?

Do you prefer to exercise on your own or with friends or in a group setting?


6. Mind-Body Connection


Rating:

Do you recognize how your are feeling emotionally/physically depending on:

Personal Growth and Development:

Physical Environment:

Nutrition:

Interpersonal Relationships:

Physical Movement: