1. If your answer to the previous question is "Disagree", then please specify that one thing you would like to change about your life.
2. How would you rate your health these days? Excellent Very good Good Fair Poor
3. 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
4. How satisfied are you with the following things in your life?
5. If you are married, how satisfied are you with your marriage? Very satisfied Satisfied Dissatisfied Very Dissatisfied
6. Please specify your gender. (Optional) Male Female
7. Please select the option that best describes your opinion regarding the following.
8. What is your age? (Optional)
9. If I had to live my life all over again, I wouldn't change anything. Agree Disagree
10. You will be happy at this very moment if ____________.
11. Please mention the three things that you think contribute significantly toward your happiness.
12. How would you rate your overall level of happiness? Very high High Average Low Very low
13. Please specify your family status. Married Living with partner Separated Divorced Widowed Single (never married) Other
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