Dr. Carolyn Chambers Clark, Award-Winning Author and Wellness Nurse Practitioner

WELLNESS SELF-ASSESSMENT - Do all the things listed below to improve your wellness

Ask yourself if you're doing the items listened below.

If you're not, choose one that has the most importance to you and set a goal to e.g., Eat one vegetable every day. Once you have that firmly in your daily regime, add another vegetable and keep improving until you're eating at least 1/2 cup of 10 vegetables or fruits a day. Rome wasn't built in a day...keep working on it.

To help you, find a positive person who is also working to become more well and coach each other along. Research shows that if you sign a contract with each other to work on a specific goal, your chances of success are greater.

Remember to be a supportive and kind coach, not a forceful one. Ask your partner how he or she would like to be coached. You can call each other daily, email, even eat a meal together or exercise together. Send each other cards in the mail. Whatever works!


I eat at least 1/2 cup of 10 vegetables a day.
I avoid candy, sweets and all sugars, including sodas
I eat whole grain breads and cereals, but only if they agree with me
I read labels on everything before I ingest it; for foods and drinks, I use organic forms whenever possible
I take supplements when unable to obtain what I need through quality food sources
I avoid processed foods, especially those that contain artificial flavors, preservatives (most deli foods) radiation (pretty much everything unless labeled organic), genetically-modified elements (most soy and corn and some wheat), and anything on the label that isn't the food being purchased
I avoid meats that contain drugs or feed additives: beef, chicken, turkey, pork e.g., unless it's been organically grown
I avoid coffee, tea, cola drinks, chocolate or other substances that are high in caffeine or stimulants.
I eat foods high in fiber every day (baked beans, vegetables and fruits, whole grain anything)
I have a good appetite, but I eat sensible amounts of food at any one time
I eat only when I'm hungry and always drink at least one glass of water first
I eat only when I feel relaxed and eat slowly, enjoying the taste sensations in my mouth
I am satisfied with when, how, and how much I eat
I drink enough water every day so that my urine is light yellow and has no odor
I know the foods and drugs I am allergic or sensitive to and never take them
I avoid drinking alcohol
I avoid all "junk foods" such as hot dogs, potato chips, beef burgers, French fries, sugary breakfast cereals, cakes, pies, most pizzas, etc.
I avoid all food or food products that have been suspected of increasing the potential for cancer, such as saccharin and any highly processed sweetener, Red No. 50, synthetic coal tar dyes, foods labeled FD and C or U.S. Certified color, bacon, sandwich meats, salami. bologna, smoked meats and fish, any food containing torula yeast or organ meats (liver, sweetbreads, kidneys)
I have installed and use a reverse osmosis water filter and only use water filtered through it for cooking, eating, and drinking. Alternatively, I have a water distiller and use only distilled water.


I weigh within ten percent of my desirable weight
I feel my body is under my control
I walk up one flight of stairs rather than taken an elevator or escaltor, and I walk or bike rather than travel by car whenever possible
I walk an hour, jog, or exercise vigorously at least three times a week
My muscles are firm and well-developed
I do flexibility or stretching exercises for at least ten minutes every day
I have a good sense of balance and walk confidently
My joints are flexible and free from pain
My eyes are clear and my vision is adequate
My hearing is good
My nose and sinuses work well
My tongue and gums are pink and healthy
I swallow food and pills easily and have minimal mucus in my throat
My neck is flexible and pain free
My skin, hair, and nails are in good condition
I don't sit for longer than 10 minutes at a time without doing stretching exercises or getting up and moving around for a few minutes.
I breathe easily and calmly
I digest my food wel
I have at least one well-formed, large bowel movement a day with ease and comfort
I am satisfied with my sexual activities
My pulse is strong, even and beats 70 times a minute or less when I'm relaxed and at rest
When I look at my body, it looks healthy and strong
When I do get sick, I'm resilient and recover quickly


I sleep well
I have a peaceful expectation about death
I live free from pain and limiting illness
I live free from disabling stress or painful, repetitive thoughts
I can laugh at myself occasionally and have a good sense of humor that doesn't belittle others
I have constructive ways of releasing my frustration and anger
I spread out predictable events and changes in my life to keep them manageable
I stay away from overly noisy, crowded, smoky or unsafe places
I respect my accomplishments
When people trample on my rights, I speak up for myself in an assertive, but not hostile, way
I allow myself to rest, be quiet, and/or meditate daily
I can say  "no" to others' requests without feeling guilty
I am satisfied with my ability to relax
If I close my eyes, I can visualize myself in a quiet, peaceful, restful scene, or I can relax parts
of my body at will
I can list the changes that are affecting me today
I feel accepting of and calm about people or things I have lost through separation or death
I feel good about my relationships with younger people or children
I feel good about my relationships with older people or my parents
I am aware of my feelings and express them to others in a way that is satisfying to me
I am able to cope with a reasonable aount of stress
I use my sense of creativity and play daily
Depending on the situation, I can move easily from seriousness to easy, good humor
I am satisfied with the amount of touch and number of hugs I give to and get from others
I look forward to each new day'I feel good about myself


I practice self-healing measures
I live with a sense of concern for others
I think my attitude and my general health are important to how well I heal
I have at least one other person with whom I can discuss my innermost thoughts and feelings
I like being alone as well as being with others
When I get tense or nervous, I try other measures before reaching for drugs or alcohol
I avoid second hand smoke and smoking
I take care so I'm not involved in "accidents"
When others need or ask for help from me, I am able to respond in a helpful way
I keep myself open to new experiences
I have good listening skills, and I listen to others' words and the feeling behind the words
I only use my cell phone for emergencies and don't keep it close to my body or other people's bodies when it's turned on


I feel I fit in my spot in the universe
I work well with different groups of people
My friends practice a wellness lifestyle
I have designed my personal environment to suit me
I have installed water filters in my shower so my skin doesn't absorb chlorine and other noxious chemicals

Conserving the earth's resources

I live in a well-insulated home
I turn lights, TV, etc. off when I'm not in the room
I buy and use as few electronic and electrical appliances and gadgets as possible
I avoid using plastics for containers, food coverings, clothes, furniture, etc.
I grow at least some of the food I eat
I eat foods that require less energy to produce (rice, beans, wheat, barley, oats, vegetable greens, tomatoes, peppers, fish, etc.)
I dress warmly in layers rather than turn on the heat, or wear fewer clothes when it's really hot
I use trimmings from uncooked fruits and vegetables to fertilize my garden
I buy recycled items when I can

Protecting myself from dangers in the environment

I buy fruits and vegetables that haven't been sprayed with pesticides and choose those labeled FDA organic in the supermartket or online
I buy organic meat, breads, etc. whenever possible
I use nutrition, exercise and self-healing measures to reduce the effect of air-borne or food-borne chemicals in my body
I refrain from using pesticides for termite treatment or gardening or my lawn; instead, I use biological control through pest management systems
I avoid using cosmetics or anything on my skin that isn't healthy; the skin is a living organ that absorbs whatever you put on it
I avoid using permanent hair dyes or cosmetics containing Yellow No. 1, Blue No. 6, and Reds Nos. 10,11,13 and 13,  the red colors used in lipstick and soap
I avoid x-rays, which are cumulative in the body; request MRI or ultrasound and only have dental x-rays for diganostic reasons every 3-5 years.
I avoid agents or solvents containing carbon tetrachloride, trichloroethylene, perchloroethylene or benzene


I persevere to get things I want or need
I know what I value, and I live according to my values
I frequently examine my values and actions to see that I am moving toward a wellness orientation
I live with a sense of purpose to my life
I know my pulse, respiration, and blood pressure
When I visit a physician, nurse, lawyer, or other professional person, I ask them how they can help me and how we can work together; if there is no working together, I consider finding a health care practitioner or other professionals who are open to doing so
I am satisfied with the amount of responsibility I take for what happens to me
I am able to make decisions in a clear, logical way
If a physician or nurse practitioner tells me I need surgery or that I am to take a medication over a long period of time, I get at least 2 other opinions and look up the procedure or drug on the internet for side effects and alternatives and discuss them with my health care practitioner
I carry a card with me at all times listing my blood type, food and drug allergies, and chronic illnesses or implants
I ask others around me not to smoke
I vote regularly and am actively involved in making this a better world, for example, signing petitions for the labeling genetically modified foods, against violence, etc.
I avoid drinking when I drive and don't ride with drivers who have been drinking
I wear seat belts when driving and insist that those who ride with me do
I know what chronic illnesses my parents and gradnparents had, and I take special steps to avoid incurring those illnesses
I balance my energy between giving to others and getting what I need
I prepare for upcoming situations by thinking them through and practicing whta I will do in the actual situation
I make sure I get sufficient vitamin D by spending at least 15 minutes (up to 45 minutes if dark-skinned) in the sun 3 times a week with my arms, legs, and face exposed without sunscreen
I check to make sure family members go to school, work, and live far away from high tension wires, chemical, mining,smelting or nuclear power plants or expressways or highways
I work to ban the use of junk or convenience foods in cateferias or schools or meetings I attend
I encourage schools to keep offering gym and exercise opportunities
I share information about dealing with bullying with my children, grand- or greatgrandchildren


To how many statements did you answer "no"?
Do you think your "nos" are representative of your state of wellness?
Do you need more information on why certain statements were included? If so, do a Google search to see what answers you can find.
Are you satisfied with your state of wellness?
If you're not satisfied, what specific steps do you plan to take so you will be more satisfied with your wellness?

Copyright, Carolyn Chambers Clark, 1980, 2013, 2014

Think positive and you'll be positive!

Google has placed ads on many pages to help me pay for this web site.They collect information about what pages you visit. If you want to know Google's privacy policy, please go to http://www.google.com/privacy_ads.html