Nawiri Self Assessment

Email *

I exercise often (at least three times a week or moderate to high intensity exercise like a brisk walk, stair climbing, jogging, swimming, running, weight lifting) *

1 (Not at all)

5 (Definitely)

My hydration *

I drink less than 1.5 liters (approximately 6 glasses) of water a day

I drink more 1.5 liters (approximately 6 glasses) or more of water a day

My sleeping patterns

I sleep less than 6hrs a night

I sleep for 6-8hrs a night

My sleeping hours are erratic

As a stay at home mom I feel sad that I am not working a paying job (skip this question if you are not a stay at home mom) *

1 (Never)

5 (Always)

I am experiencing perimenopause symptoms (hot flashes, sluggish memory, brain fog, tingling ears, changes in menses, changes in sex drive, trouble sleeping, and others) *

1 (Not at all)

5 (Definitely)

I have experienced significant weight gain (More than 10 kg or more than 22 pounds in the last five years) *

Yes

I feel anxious, depressed and irritable *

1 (Never)

5 (Always)

I feel overwhelmed and constantly worry *

1 (Never)

5 (Always)

I experience mood swings *

1 (Never)

5 (Always)

I struggle to balance work and family responsibilities *

1 (Not at all)

5 (Definitely)

I am experiencing a strain in one or more of my significant relationships *

1 (Not at all)

5 (Definitely)

I am experiencing significant financial pressure to meet my family's needs *

1 (Not at all )

5 (Definitely)

I feel fulfilled and satisfied with my career achievements *

1 (Not at all)

5 (Definitely)

I have a fun, and emotionally fulfilling circle of friends that I interact with regularly *

1 (Not at all)

5 (Definitely)

I have a hobby or hobbies that I engage in regularly *

Yes

I am dealing with personal illness, or illness in my spouse, children or parents *

Yes

I am currently in a career transition (changed jobs, started a business in the last one year) *

Yes