Quantum Vitality Life Balance Questionnaire Email Personal Information First Name * Last Name * Email Address * How Happy Are You Now in Each Area? Rate yourself on how happy you are now in each area (from 1-10, where 1 is poor and 10 is optimal). Relating to Body/Posture/Food/Exercise * Attitude/Emotions * Finances * Family/Intimate Relationships * Relating to People/Friends/Business * Spirituality * Career/Learning/Personal Growth * Creativity/Play/Recreation * Evaluate Your Life Balance What are the Most Important Areas of Your Life? Check only 3 * Relating to Body/Posture/Food/Exercise Attitude/Emotions Finances Family/Intimate Relationships Relating to People/Friends/Business Spirituality Career/Learning/Personal Growth Creativity/Play/Recreation Your Top Goals Please list your top goals for the 3 most important areas of your life * Thank you for completing the Quantum Vitality Life Balance Questionnaire! Dr. Victoria Moore, DC, MA