Starting Point #4: Physical Dimension of Wellness

Exercise Confidence Survey

On a scale of 1-5 rate your exercise confidence

v I can stick to an exercise program even on the weekends

1................ 2...................3......................4.................... 5

I know I cannot............Maybe.............................. I know I can

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v I can stick to an exercise program even after a long tiring day

1................2...................3......................4..................... 5

I know I cannot......... Maybe................................ I know I can

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v I can stick to an exercise program when I have social obligations

1............. 2.................. 3.......................4...................... 5

I know I cannot .......Maybe.................................. I know I can

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v I can stick to an exercise program even when I am feeling blue

1.............2....................3......................4........................5

I know I cannot....... Maybe.................................. I know I can

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v I can stick to an exercise program even when I am busy

1.............2...................3.......................4........................5

I know I cannot....... Maybe.................................. I know I can

Exercise Confidence Survey

The purpose of this survey is to begin your journey toward self-assessment concerning your optimal well-being. After taking this brief survey and adding your scores together, take a moment and reflect on your schedule and best times to exercise. You will find that if your overall confidence score was high you will have a better chance to stay self-motivated and focused on your fitness program. If your exercise confidence number was low then you may benefit from strategies that help with exercise adherence such as working out with a friend.