Dimension 1: Emotional Wellness
Please indicate for each of the five statements which is the closest to how you have been feeling over the last two weeks.
Dimension 2: Social Wellness
Please read each of the following statements and rate the extent to which it describes your feelings about your relationships. How often were these statements true for you in the last two weeks?
1) There is a person who is around when I am in need.
2) There is a person with whom I can share my joys and sorrows.
3) My family really tries to help me.
4) I get the emotional help and support I need from my family.
5) I have a person who is a real source of comfort to me.
6) My friends really try to help me.
7) I can count on my friends when things go wrong.
8) I can talk about my problems with my family.
9) I have friends with whom I can share my joys and sorrows.
10) There is a person in my life who cares about my feelings.
11) My family is willing to help me make decisions.
12) I can talk about my problems with my friends.
Dimension 3: Spritual Wellness
Please read the following statements related to spiritual wellness and rate the extent to which you agree with them at this time.
1) I feel like my life has purpose and meaning.
2) I spend time outdoors in nature.
3) I engage in acts of caring and goodwill without expecting something in return.
4) I have found a balance between meeting my needs and those of others.
5) I feel connected to something larger than myself (e.g., supreme being, nature, connectedness of all living things, humanity, community).
Dimension 4: Physical Wellness
Please read the following statement regarding physical health and select the most accurate answer for you at this time.
1) In general, would you say your health is poor, somewhat good, good, very good, or excellent?
Dimension 5: Workplace Wellness
Please read the following statements regarding workplace wellness and indicate how much you agree with them at this time.
1) I feel misunderstood or unappreciated by my co-workers.
2) My work is emotionally draining.
3) I have negative thoughts about my job.
4) My workload is not manageable.
5) I feel that change is not managed well in my workplace.
Dimension 6: Intellectual Wellness
Please read the following statements regarding intellectual wellness and rate the extent to which they are true for you at this time.
1) I seek personal growth by learning new skills.
2) I manage my time well, rather than it managing me.
3) I am confident in my ability to find solutions to my problems.
Demographic Information
Please indicate how much you agree with the following statements:
1) Do you currently work in Extension?
2) What is your current age?
3) How would you describe yourself? Please select all categories that apply.
4) How would you describe your gender?
5) What state do you currently live in?