Quality of life survey
0%
1
.
You would rate the quality of your life as:
*
You can give only one answer.
very low
low
medium
high
very high
2
.
In one sentence, please specify the reason for this choice:
*
3
.
Please specify your level of satisfaction with particular areas of life:
*
You can give only one answer in a row.
very dissatisfied
dissatisfied
moderately satisfied
satisfied
very satisfied
health
health -
very dissatisfied
health -
dissatisfied
health -
moderately satisfied
health -
satisfied
health -
very satisfied
finances
finances -
very dissatisfied
finances -
dissatisfied
finances -
moderately satisfied
finances -
satisfied
finances -
very satisfied
job
job -
very dissatisfied
job -
dissatisfied
job -
moderately satisfied
job -
satisfied
job -
very satisfied
education
education -
very dissatisfied
education -
dissatisfied
education -
moderately satisfied
education -
satisfied
education -
very satisfied
family relations
family relations -
very dissatisfied
family relations -
dissatisfied
family relations -
moderately satisfied
family relations -
satisfied
family relations -
very satisfied
love
love -
very dissatisfied
love -
dissatisfied
love -
moderately satisfied
love -
satisfied
love -
very satisfied
friendship
friendship -
very dissatisfied
friendship -
dissatisfied
friendship -
moderately satisfied
friendship -
satisfied
friendship -
very satisfied
place of residence
place of residence -
very dissatisfied
place of residence -
dissatisfied
place of residence -
moderately satisfied
place of residence -
satisfied
place of residence -
very satisfied
look
look -
very dissatisfied
look -
dissatisfied
look -
moderately satisfied
look -
satisfied
look -
very satisfied
physical condition
physical condition -
very dissatisfied
physical condition -
dissatisfied
physical condition -
moderately satisfied
physical condition -
satisfied
physical condition -
very satisfied
free time
free time -
very dissatisfied
free time -
dissatisfied
free time -
moderately satisfied
free time -
satisfied
free time -
very satisfied
4
.
Please specify how much joy is in your life?
*
You can give only one answer.
very little
little
medium
much
very much
5
.
What gives you the most joy?
*
You can select several answers.
spending time with family
partying
doing sports
watching TV
spending time with friends
food
traveling
sleeping
working
consumption of alcohol/stimulants
studying
hobby
other: what?
6
.
Please specify how important the following issues are in your life:
*
You can give only one answer in a row.
not important at all
not important
neutral
important
very important
job
job -
not important at all
job -
not important
job -
neutral
job -
important
job -
very important
education
education -
not important at all
education -
not important
education -
neutral
education -
important
education -
very important
money
money -
not important at all
money -
not important
money -
neutral
money -
important
money -
very important
family
family -
not important at all
family -
not important
family -
neutral
family -
important
family -
very important
friends
friends -
not important at all
friends -
not important
friends -
neutral
friends -
important
friends -
very important
hobby
hobby -
not important at all
hobby -
not important
hobby -
neutral
hobby -
important
hobby -
very important
love
love -
not important at all
love -
not important
love -
neutral
love -
important
love -
very important
travels
travels -
not important at all
travels -
not important
travels -
neutral
travels -
important
travels -
very important
faith
faith -
not important at all
faith -
not important
faith -
neutral
faith -
important
faith -
very important
fashion
fashion -
not important at all
fashion -
not important
fashion -
neutral
fashion -
important
fashion -
very important
social prestige
social prestige -
not important at all
social prestige -
not important
social prestige -
neutral
social prestige -
important
social prestige -
very important
7
.
Do you think your life has meaning?
*
You can give only one answer.
yes
no
8
.
Please list three things that give your life meaning:
9
.
Do you have dreams?
*
You can give only one answer.
yes, I try to make them come true
yes, but they're just dreams - I don't do anything to make them come true
no, I used to have dreams, but not now
no, I've never had a dream
not now, I've already made my dreams come true
10
.
If you would like to change something in your life, it would be:
*
You can select several answers.
I don't want to change anything
having children
passion / hobby
relationship with the family
education
faith
love
work
appearance
relationship with friends
finances
weight
relationship with a partner
way of spending free time
other issues: what?
11
.
Please specify to what extent you feel comfortable in the following situations:
*
You can give only one answer in a row.
not comfortable at all
rather not comfortable
moderately comfortable
rather comfortable
completely comfortable
among friends
among friends -
not comfortable at all
among friends -
rather not comfortable
among friends -
moderately comfortable
among friends -
rather comfortable
among friends -
completely comfortable
among the family
among the family -
not comfortable at all
among the family -
rather not comfortable
among the family -
moderately comfortable
among the family -
rather comfortable
among the family -
completely comfortable
among strangers
among strangers -
not comfortable at all
among strangers -
rather not comfortable
among strangers -
moderately comfortable
among strangers -
rather comfortable
among strangers -
completely comfortable
in the family home
in the family home -
not comfortable at all
in the family home -
rather not comfortable
in the family home -
moderately comfortable
in the family home -
rather comfortable
in the family home -
completely comfortable
with my partner
with my partner -
not comfortable at all
with my partner -
rather not comfortable
with my partner -
moderately comfortable
with my partner -
rather comfortable
with my partner -
completely comfortable
at work/school
at work/school -
not comfortable at all
at work/school -
rather not comfortable
at work/school -
moderately comfortable
at work/school -
rather comfortable
at work/school -
completely comfortable
in the crowd
in the crowd -
not comfortable at all
in the crowd -
rather not comfortable
in the crowd -
moderately comfortable
in the crowd -
rather comfortable
in the crowd -
completely comfortable
during public speaking
during public speaking -
not comfortable at all
during public speaking -
rather not comfortable
during public speaking -
moderately comfortable
during public speaking -
rather comfortable
during public speaking -
completely comfortable
abroad
abroad -
not comfortable at all
abroad -
rather not comfortable
abroad -
moderately comfortable
abroad -
rather comfortable
abroad -
completely comfortable
in the night
in the night -
not comfortable at all
in the night -
rather not comfortable
in the night -
moderately comfortable
in the night -
rather comfortable
in the night -
completely comfortable
in your own home
in your own home -
not comfortable at all
in your own home -
rather not comfortable
in your own home -
moderately comfortable
in your own home -
rather comfortable
in your own home -
completely comfortable
alone
alone -
not comfortable at all
alone -
rather not comfortable
alone -
moderately comfortable
alone -
rather comfortable
alone -
completely comfortable
12
.
Please specify how often do You feel sad or depressed?
*
You can give only one answer.
very rarely
rarely
sometimes
often
very often
13
.
Please specify how often do You feel happy, glad or joyful?
*
You can give only one answer.
very rarely
rarely
sometimes
often
very often
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