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The eight sections in the Wheel of Life represent balance. Seeing the centre of the wheel as 0 and the outer edge as 10, please rank you level of satisfaction with each life area by assigning the appropriate number and entering any additional comments into the sections below. Please note the roll over below is only a graphical representation. All responses should be filled out in the forms section.

Roll Over for example:

Wheel of Life Intentions (Goals)

Full Name: (Please include on all Forms)

Physical Environment




Friends & Family

Significant Other/Romance

Spirituality/ Personal Growth

Fun & recreation

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