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Motivational Assessment: YOUR Wellness Approach

This brief assessment invites you to reflect on YOUR goals, motivations, and what matters most to you right now. Your responses will provide insights to your current priorities and assist in tailoring a wellness approach that aligns with your journey. It will also help determine whether HIW may be a good fit for your next steps.

Please choose up to 3 responses (your prioties) for each question unless otherwise noted... There are no right or wrong answers—just what feels true for you.

First name*

Last name*

Email*

What motivates you to improve your health? Please choose up to 3

Enhance physical health and fitness

Improve mental and emotional well-being

Manage weight in a balanced way

Address specific health concerns

Boost energy

Support recovery from injury or surgery

Strengthen immune health

Prepare for a specific event or challenge (e.g., marathon)

Follow recommendations from loved ones or health professionals

Build on progress already accomplished

Increase science-informed wellness awareness

Why do you want a healthier lifestyle? Please choose up to 3:

For longevity and a better quality of life

To set a positive example for others

To move forward after a health scare or medical advice

For personal growth and self-satisfaction

To prevent future health issues

To enhance cognitive function and mental clarity & focus

To better manage stress and sustain calm

To reach personal milestones and achievements

What are your main health and wellness goals? Please choose up to 3:

Nourish myself with tasty REAL foods that supports my health

Build a consistent movement routine

Strengthen stress resilience and mental clarity

Reach a fitness or weight goal through balanced living

Improve sleep quality

Strengthen bones and muscles

Improve flexibility and balance

Build more meaningful connections and support

Expand my understanding of health and wellness

What have you already tried? Choose up to 3.

Made and sustained some positive changes

Tried but couldn’t sustain improvements

Multiple attempts with mixed success

Haven’t tried making changes before

Participated in wellness challenges or programs

Sought professional health or nutritional advice

Used tracking tools or apps

Engaged in mindfulness, meditation, or similar practices

Sought constructive support and accountability

Connected with a sense of higher purpose or spirituality for motivation

What challenges have you faced in modifying lifestyle habits? Please choose up to 3:

Lack of time or a busy schedule

Financial or resource limitations

Difficulty sustaining motivation

Health issues or physical limitations

Unclear goals or knowledge gaps

Conflicting or overwhelming information

Limited access to safe exercise spaces and/or services

Emotional barriers such as stress, anxiety, or low mood

Cultural or social pressures

All of the above

What would you most like to focus on first? Please choose 1

Nutrition and daily food choices

Movement and physical vitality

Stress, emotional balance, and clarity

Sleep and restoration

Weight-related goals

Building consistency and daily rhythm

Understanding what approach fits me best

Navigating resistance from family or friends

Is there anything else you would like us to know about your goals, interests, or current situation? Short answer

HIW

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