If you could do anything, what would you do?
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One year from now, if you could change only ONE thing about your life, which of these would it be?
Change careers/Start a new job
Lose weight
Go back to school/continue education
Volunteer to help others
Develop a new skill or talent (like writing, music, etc.)
Get organized
Work less/Play more
Break an unhealthy habit (such as smoking, alchohol, overeating)
Exercise more/Get fit
Travel more/Take a trip
Get more in touch with my spiritual or religious side
Go Back to School
Get out of debt or save more money
Spend more time with family & friends
Other  
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How long have you considered making the above change?
Just started thinking about it
Within the last two years
Two to five years
Five to 10 years
More than 10 years
What is the biggest barrier you have faced to making the change?
I can't find the time
It would take too much emotional energy
It would take longer than I want
I don't have support from my families & friends
I don't know where to begin
I'm concerned what others will think
I am afraid I'll fail & be embarrassed
It's unrealistic; people like me don't do that
It's too risky
I'd have to turn my whole life upside down
Other  
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Suppose you were successful in your goal, what would be different for you? (Select all that apply.)
My relationship(s) would be better
My health would improve
My finances would be better
My overall outlook on life would be better
I don't know what would improve
Nothing would be different
Other  
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If you could assign a dollar value to it, how much is it worth to you to be able to finally make the change(s) you've wanted?
Practically nothing
Less than $500
$500-$1500
$1500-$5000
More than $5000
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How motivated are you to make this change -- right now?
Not at all
Thinking About It
Unsure
I'm real Close
I'm on Fire!
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