| (Dissatisfied) 1 - 2 - 3 - 4 - 5 (Satisfied) | |
| Satisfaction | |
| a. Your family | _________________ |
| b. Your career | _________________ |
| c. Your marriage | _________________ |
| (Dissatisfied) 1 - 2 - 3 - 4 - 5 (Satisfied) | |
| Satisfaction | |
| a. Your family | _________________ |
| b. Your career | _________________ |
| c. Your marriage | _________________ |