Personal Data Inventory

You are ...

Are you married?

Do you have any chronic conditions?

Have you ever used drugs for anything other than medical purposes?

Have you ever been arrested?

Do you drink alcoholic beverages?

Do you drink coffee and/or other caffeine drinks?

Do you smoke?

Have you ever had interpersonal problems on the job?

Have you ever had a severe emotional upset?

Have you ever seen a psychiatrist or a counselor?

Member?

Do you believe in God?

Do you pray?

Would you say you are a Christian?

How often do you read your Bible?

Abuse

Anger

Anxiety

Apathy

Appetite

Bitterness

Change in Lifestyle

Children

Communication

Conflict (fights)

Deception

Decision-making

Depression

Drunkenness

Envy

Fear

Finances

Gluttony

Grief

Guilt

Health

Homosexuality

Impotence

Infertility

In-laws

Loneliness

Lust

Memory

Moodiness

Perfectionism

Pornography

Rebellion

Sex

Sleep

A Vice

Other