Rooted Survey 1. I feel a sense of safety and security within my physical and mental environments. True False Unknown 2. I know what resources are available to help meet my basic needs of food, shelter, housing, and medical care. True False Unknown 3. I am able to feel my feelings without numbing them or becoming overwhelmed by them. True True False Unknown 4. I know how to create and maintain healthy relationships. True False Unknown 5. I believe in my worth and know my purpose. True False Unknown 6. I am self-aware and in touch with my likes, dislikes, strengths, and weaknesses. True False Unknown 7. I am able to treat myself with compassion. True False Unknown 8. I make time for self-care. True False Unknown 9. I know what my core values are and how to create and maintain boundaries that support them. True False Unknown 10. I engage in meaningful work whether paid or unpaid. True False Unknown 11. I am able to call upon my intuition to practice authenticity of self. True False Unknown 12. I am comfortable with change and have a growth mindset. True False Unknown 13. I have a belief system that provides me with a sense of connection and belonging to the world. True False Unknown 14. I possess the skills necessary to create the changes I need to feel connected, nourished, and empowered. True False Unknown Thank you!
