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Valued Living Questionnaire

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Valued Living Questionaire

Below are areas of life that are valued by some people. We are concerned with your quality of life in each of these areas. One aspect of quality of life involves the importance one puts on different areas of living. Rate the importance of each area on a scale of “not important to “most important.” Not everyone will value all these areas, or value all areas the same. Rate each according to your personal sense of importance.

    • Not Important Mostly Unimportant Little Importance Somewhat Important Important Very Important Most Important
      Family (other than marriage or parenting)
      Marriage/Couples/Intimate Rel.
      Parenting
      Friends/Social Life
      Work
      Education/Training
      Recreation/Fun
      Spirituality
      Citizenship/Community
      Physical Health (diet, exercise, sleep)
      Other:

During the Past Week

In this section, we would like you to give a rating of how consistent your actions have been with each of your values. We are not asking about your ideal in each area. We are also not asking what others think of you. Everyone does better in some areas than others. People also do better at some times than at others. We want to know how you think you have been doing during the past week. Rate each area on a scale of “not consistent” to “completely consistent.”

  • Not Consistent at All Mostly Inconsistent Somewhat Inconsistent Somewhat Consistent Mostly Consistent Almost Completely Consistent
    Family (other than marriage or parenting)
    Marriage/Couples/Intimate Rel.
    Parenting
    Friends/Social Life
    Work
    Education/Training
    Recreation/Fun
    Spirituality
    Citizenship/Community
    Physical Health (diet, exercise, sleep)
    Other: