Wheel Of Life

Welcome to the Wheel Of Life Survey
So we can provide you with your results. Please enter your details below.
Whats your name?*
Full Name
Phone number to reach you (if needed)?*
Email address (to send your results to)?*

(Please ensure spelling is correct)
How Did You Hear About Dr Espen?
What is your Facebook name? This is the fastest way we can give you online support. Enter it here:
Where do you want to be in 12 months from today?
Looking at the 8 areas of life above, please give us as much detail as possible. Describe EXACTLY what you want your life to look like. Don't hold back and don't be afraid to dig deep and dream big; pretend fear doesn't exist while answering this question.
What are the 3 biggest road blocks in your life right now?
Do you have a personal or professional vision for your life? If so what is it?
If you have any additional questions or comments for our coaching team, then please enter here:

Instructions:
Rate the following 8 areas in your life between 1-10
1 = I am currently at rock bottom and not reaching any amount of the potential I have
10 = I have reached full potential and am completely fulfilled, inspired and empowered in this area of life.
Please note that this is not how you WANT your life to be but how it actually IS. If you want to be in a relationship and you are NOT in a relationship then you are at 0 (for an example not 10 for the effort of looking for one). The more honest you are with yourself, the better your analysis and your results moving forward.
1. Mental and Emotional State?*
Rate this aspect in your life in a scale of 1 (lowest) to 10 (highest).
How does your score above make you feel? (optional)

Career/Vocation?*
Rate this aspect in your life in a scale of 1 (lowest) to 10 (highest).
How does your score above make you feel? (optional)

Relationships?*
Rate this aspect in your life in a scale of 1 (lowest) to 10 (highest).
How does your score above make you feel? (optional)

Financial?*
Rate this aspect in your life in a scale of 1 (lowest) to 10 (highest).
How does your score above make you feel? (optional)

Physical Health?*
Rate this aspect in your life in a scale of 1 (lowest) to 10 (highest).
How does your score above make you feel? (optional)

Spiritual Fulfillment/Purpose?*
Rate this aspect in your life in a scale of 1 (lowest) to 10 (highest).
How does your score above make you feel? (optional)

Personal Development ?*
Rate this aspect in your life in a scale of 1 (lowest) to 10 (highest).
How does your score above make you feel? (optional)
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Mental and Emotional State? CALCULATION
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Career/Vocation? CALCULATION
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Relationships? CALCULATION
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Time? CALCULATION
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Financial? CALCULATION
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Physical Health? CALCULATION
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Spiritual Fulfillment/Purpose? CALCULATION
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Personal Development ? CALCULATION
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Total(SUM) CALCULATION
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GAP/IMPROVEMENT(SUM) CALCULATION

Welcome to the Wheel Of Life Survey