DREAM Score Questionnaire: Page 4

Name*
First Last
On a scale of 1 to 10, how much do you agree with the below statements?
I strive to maintain balance in every aspect of my life.*
Absolutely Disagree 1 2 3 4 5 6 7 8 9 Absolutely Agree 10
I am conscious of how I carry myself (posture)*
Absolutely Disagree 1 2 3 4 5 6 7 8 9 Absolutely Agree 10
When I have a "trauma" to my body, I seek care to fix a resulting issue rather than just letting it go or treating the symptom.*
Absolutely Disagree 1 2 3 4 5 6 7 8 9 Absolutely Agree 10
When lifting heavy objects, I am conscious of my body and lift properly (bend at the knees, etc…)*
Absolutely Disagree 1 2 3 4 5 6 7 8 9 Absolutely Agree 10
When I exercise, I maintain optimal form throughout each activity.*
I don't exercise Absolutely Disagree 1 2 3 4 5 6 7 8 9 Absolutely Agree 10
I wear footwear that supports a natural stride*
Absolutely Disagree 1 2 3 4 5 6 7 8 9 Absolutely Agree 10
I see a chiropractor at least twice per year to ensure optimal communication between my brain & my body and proper alignment.*
Absolutely Disagree 1 2 3 4 5 6 7 8 9 Absolutely Agree 10
I get routine bodywork (including massage), exercise regularly, eat healthy foods, maintain a positive attitude and stay well rested.*
Absolutely Disagree 1 2 3 4 5 6 7 8 9 Absolutely Agree 10
I strive to limit chemical stressors in my life (pollution, drugs/medications, non-organic foods, pesticides, etc…)*
Absolutely Disagree 1 2 3 4 5 6 7 8 9 Absolutely Agree 10
I strive to limit emotional stressors in my life (drama, people with drama, "toxic" family or friends)*
Absolutely Disagree 1 2 3 4 5 6 7 8 9 Absolutely Agree 10

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DREAM Score Questionnaire: Page 4

On a scale of 1 to 10, how much do you agree with the below statements?