Instructions: For each category, rate how peaceful you feel on a scale of 1 to 5, where 1 = Not at all peaceful and 5 = Completely peaceful.

Please keep track of your answers to total at the end

How peaceful do you feel in your relationships with family, friends, and other important people in your life? *

How peaceful do you feel when it comes to managing and expressing your emotions? *

How peaceful do you feel about the state of your home, belongings, and physical surroundings? *

How peaceful do you feel about the structure of your daily schedule and your ability to manage tasks? *

How peaceful do you feel about your self-care and how well you manage your own needs most days? *

Your Peace Score

Full Name *

Email *

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