Family Life Satisfaction Survey (for Parent Coaching)

Please rate your current levels of life satisfaction on a scale from 0-10 in the following areas. 0 represents completely dissatisfied and 10 represents completely satisfied. 

1. Sleep 🔲
2. Physical activity 🔲
3. Nutrition 🔲
4. Stress management 🔲
5. Close bonds 🔲
6. Shelter and safety 🔲
7. Quality time 🔲
8. Behavior management 🔲
9. Accomplishments 🔲
10. External social support 🔲
11. Positive contributions 🔲
12. Fun and leisure 🔲
13. Work/life balance 🔲
14. Parenting style 🔲
15. Involvement 🔲
16. Community environment 🔲
17. Financial security 🔲
18. Communication 🔲
19. Positive emotions 🔲
20. Conflict management 🔲

Which of these areas stand out as something you'd like to work on during our time together? 

Let's set some coaching plan goals.

1. I want to..................
2. I want to..................

Example goal statement: I want to learn how to manage my stress in healthy ways.

Tip: Coaching goals are actionable, tangible, and measurable.
• Example intangible goal: I want to be happier.
• Example tangible goal: I want to identify what makes me happy.