Wellbeing Check-In Sheet

Who this is for

A one-page check-in with yourself. You list the areas that matter to you — sleep, movement, food, people, work, rest, whatever they are — write how each is going in your own words and one small thing you could do, then answer a few prompts at the foot. No score, no scale and no verdict.

Anyone who wants to stop once in a while and take stock on paper — at the turn of a month, after a hard stretch, before a conversation with somebody they trust — and anyone who prefers a sheet with nothing on it that tells them how they are.

What this helps you track

• The areas of your life you decide to look at, in your own list
• How each is going right now, in a sentence of your own
• One small thing for each, sized so it might actually happen
• What is taking up room, what is going well and what you want to be different
• A dated page to compare with the last one, and to take to someone if you choose to

How to use it

1. Write the date and, in a sentence, how things are right now — before you look at any of the areas.
2. List the areas you want to check on, one per row. Use the same list each time so the sheets compare, and change it when your life does.
3. Write how each area is going in your own words. Plain and honest beats tidy.
4. For each, write one small thing — the smallest change that would help, not a plan.
5. Answer the prompts at the foot: what is taking up most room, what is going well, what you want to be different by the next check-in, and whether there is anything you want to talk to someone about.
6. Date the next check-in, keep this sheet, and read it before you fill in the next one.

Formats

• Printable PDF (A4 and US Letter)
• Fillable PDF with form fields
• Fill in online, saved in your browser

The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The online version keeps what you enter in your own browser and builds the completed PDF on your device.

How to print

Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.

Questions

Is there a score or a scale?

No. Nothing on the sheet is rated, totalled or compared with a norm. Each area gets a sentence in your words, and the sheet has no opinion about what that sentence means.

Which areas should I list?

Whichever matter to you. Sleep, movement, food, people, work, money, rest and home are common starting points; the list is yours and can be as long or short as the rows allow.

Is this a mental health assessment?

No. It is a sheet of prompts for taking stock, and it diagnoses nothing. If a pattern across your check-ins worries you, that is a conversation for a doctor, counsellor or other professional, and the sheets are a useful thing to take along.

How often should I do it?

Whenever suits you. There is a field for the date of the next one and no interval of ours; monthly, seasonally and after big events are all used.

Can I show it to someone?

Yes, and the last prompt is there for that: anything you want to talk to someone about, written down before the conversation so it does not get lost in it.