1 – Strongly disagree
2 – Disagree
3 – Agree
4 – Strongly agree
¹
1
2
3
4
1
I have a positive outlook toward life.
2
I have short and/or long range goals.
3
I feel all alone.
4
I can see possibilities in the midst of difficulties.
5
I have a faith that gives me comfort.
6
I feel scared about my future.
7
I can recall happy/joyful times.
8
I have deep inner strength.
9
I am able to give and receive caring/love.
10
I have a sense of direction.
11
I believe that each day has potential.
12
I feel my life has value and worth.
The presented answer sheet is not an original form and is not intended for printing or use as a handout.
The answer numbers are used only to label response columns. They are NOT scores and should not be used for calculating results.