SELF MANAGEMENT

STRESS MANAGEMENT
1. At bedtime, I fall asleep easily. 1 2 3 4
2. I get along well in school. 1 2 3 4
3. If awakened, I easily fall asleep again 1 2 3 4
4. I control nervous habits (eg. nail biting). 1 2 3 4
5. I take 15-20 minutes a day to do what I want. 1 2 3 4
6. I accept things I can’t change. 1 2 3 4
7. I get along with my family. 1 2 3 4
8. I make sure I take time each day to relax. 1 2 3 4
9. I avoid using pot/alcohol to relieve tension. 1 2 3 4
10.I am happy with my life. 1 2 3 4

Total: 34
 
NUTRITION
1. I eat one raw fruit or vegetable every day. 1 2 3 4
2. I drink fewer than five soft drinks a week. 1 2 3 4
3. I avoid adding salt at the table. 1 2 3 4
4. I eat whole grain bread and cereal daily. 1 2 3 4
5. I read and understand food labels. 1 2 3 4
6. I stay within ten pounds of my ideal weight. 1 2 3 4
7. I avoid eating sugared cereal. 1 2 3 4
8. I avoid sweet or highly salted snacks. 1 2 3 4
9. I eat a nutritious breakfast. 1 2 3 4
10.I avoid eating fried foods. 1 2 3 4

Total: 29


PHYSICAL FITNESS
1. I climb stairs rather than use elevators. 1 2 3 4
2. I regularly bike, run, or walk for exercise. 1 2 3 4
3. I do some other strenuous activity at least 1 2 3 4 twice a week.
4. I warm up before doing hard exercise. 1 2 3 4
5. I like to exercise. 1 2 3 4
6. I can jog for 15 minutes and not be winded. 1 2 3 4
7. I have enough energy to get through my day. 1 2 3 4
8. I do stretching exercises twice a week. 1 2 3 4
9. I avoid riding when I can walk. 1 2 3 4
10.Physical activity is part of my life. 1 2 3 4

Total: 27


SAFETY
1. I protect my home from fire and safety hazards. 1 2 3 4
2. I protect myself from pregnancy and/or STD’s. 1 2 3 4
3. I avoid smoking cigarettes. 1 2 3 4
4. I avoid riding with a drinking driver. 1 2 3 4
5. I avoid abusing drugs, including alcohol. 1 2 3 4
6. I collect papers, cans, and glass for recycling. 1 2 3 4
7. When riding a bike, skateboard, motorcycle, Roller-blades etc., I wear a helmet. . 1 2 3 4
8. I’d avoid driving if I’d been drinking. 1 2 3 4
9. I wear a seat belt in cars. 1 2 3 4
10.My immunizations are up-to-date. 1 2 3 4

Total: 40


SELF-IMAGE
1. It is easy for me to laugh. 1 2 3 4
 2. I can accept compliments. 1 2 3 4
3. I am able to give honest compliments. 1 2 3 4
4. I act according to my values. 1 2 3 4
5. I look forward to the future. 1 2 3 4
6. At times, I like to be alone. 1 2 3 4
7. I think it’s okay to express my feelings. 1 2 3 4
8. I plan my time wisely. 1 2 3 4
9. I listen to and accept good advice. 1 2 3 4
10.I seek help if I have a problem. 1 2 3 4

Total: 40


HEREDITY-
One of my close relatives has had: Yes No
1. Heart Disease: Yes
2. High Blood Pressure: Yes
3. Cancer: Yes
4. Diabetes: No
5. Glaucoma: No
6. Asthma: Yes
7. Alcoholism: No
8. Mental Illness: Yes
9. Stroke: Yes
10.Arthritis: No


Three ways to improve category with lowest score:
1. Diet. Try to eat regularly and lesser than usual.
2. Exercise more. Maybe around twice a week. The more it is, the better it is going to be
3. Be more positive because if you are a negative person, the possibility of getting sick or stress will be easier.