Surveyonics - Online Survey Software
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Measuring Happiness-Measuring Well-being
For your convenience and ease of reference, we have created a template of The Happiness Survey. You can use this template as such or modify it to suit your needs. Alternatively, you can design your own survey from scratch.

 Question: What is your age? (Optional)
 Question: Please specify your gender. (Optional)
Male
Female
 Question: What is the highest level of education you have completed? (Optional)
High School Diploma
Associate Degree
Bachelor Degree
Master's Degree
PhD or Professional Degree (J.D.,M.D.etc.)

Other
 Question: If I had to live my life all over again, I wouldn't change anything.
Agree
Disagree
 Question: You will be happy at this very moment if ____________.
 Question: Please specify your family status.
Married
Living with partner
Separated
Divorced
Widowed
Single (never married)

Other
 Question: If you are married, how satisfied are you with your marriage?
Very satisfied
Satisfied
Dissatisfied
Very Dissatisfied
 Question: If your answer to the previous question is "Disagree", then please specify that one thing you would like to change about your life.
 Question: How would you rate your overall level of happiness?
Very high
High
Average
Low
Very low
 Question: How satisfied are you with the following things in your life?
Very satisfiedSatisfiedDissatisfiedVery Dissatisfied
The way your career has progressed
The home you live in
The leisure time you get
Your financial situation
 Question: How would you rate your health these days?
Excellent
Very good
Good
Fair
Poor
 Question: Please select the option that best describes your opinion regarding the following.
Strongly agreeModerately agreeSlightly agreeSlightly disagreeModerately disagreeStrongly disagree
I feel I matter a lot to both myself and others
I feel comfortable in my own skin
I have most of the things that make life comfortable
I am content with my life
I am optimistic about future
I have trouble falling asleep and I usually don't get a restful sleep
I find beauty in so many things around me
My past experiences have left me bitter
I am critical of others
I enjoy the company of friends and relatives
 Question: Please mention the three things that you think contribute significantly toward your happiness.
One
Two
Three