Instructions 1. In the Wellness Dimension chart below, record the date at the top of the first column, then fill in that column using the following scale to indicate your wellness rating for each dimension: poor = 5, fair = 4, average = 3, good = 2, excellent = 1 2. Next, write a goal that you want to accomplish prior to the end of this course for each wellness dimension, and list three specific objectives that will help you accomplish each goal. 3. Once a month, review this form, fill in another column of self-evaluation, and adjust your objectives as necessary. Here's an example: Social goal: to improve my social life at school Social goal: Specific objectives 1. Specific objectives Find study buddies. Ask each instructor and counselor about study 1. groups. 2. Attend Friday night discussion groups in Student Center. Locate activities I enjoy-basketbal, chess, dancing-and start a 3. conversation 2. 3. Date Environmental goal: Specific objectives 1. 2. Wellness Dimension Physical Emotional Social Environmental Mental Spiritual Occupational 3. Mental goal: Specific objectives 1. Goals and Objectives 2. 3. Physical goal: Specific objectives Spiritual goal: 1. Specific objectives 2. 1. 3. 2. 3. Emotional goal: Specific objectives Occupational goal: 1. Specific objectives 2. 1. 3. 2. 3