First Name
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Last Name
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Phone
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Email
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Q1. Under pressure, I can regulate my emotions without becoming reactive.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q2. I recover quickly after setbacks or unexpected disruptions.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q3. I can handle rejection without losing momentum for long.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q4. Failure usually becomes feedback for me, not a reason to shut down.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q5. I make important decisions without excessive second-guessing.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q6. I can make decisions even when there is not perfect certainty.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q7. I trust my judgement when the stakes are high.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q8. I can distinguish between a real risk and fear-based hesitation.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q9. I am clear on the direction I am building toward over the next 6–12 months.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q10. I know which priorities matter most in this season of growth.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q11. My current direction is clear enough to guide what I say yes and no to.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q12. I translate priorities into specific next actions rather than leaving them as intentions.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q13. My major priorities are broken down into practical tasks with realistic time frames.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q14. My calendar and workflow reflect what matters most, not just what feels urgent.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q15. I have clear systems or routines that support consistent follow-through.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q16. I trust myself to follow through on what I commit to.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q17. I can rely on the key people around me when support is needed.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q18. If I have a team, I trust them enough to delegate meaningful responsibility. OR I have people around me I can trust to support important outcomes.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q19. I have strong personal support structures outside of work, such as family, friends, or mentors.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q20. I have a stable sense of who I am beyond performance, status, or approval.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q21. My inner critic does not usually dominate my thinking, nervous system, or performance.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q22. My personal standards shape my behaviour more than pressure, fear, or comparison.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q23. I regularly generate valuable ideas, opportunities, or improvements.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q24. I naturally see possibilities that others miss.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q25. My thinking is both creative and commercially useful.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q26. I have someone outside myself who holds me accountable to the standards I say matter.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q27. I actively seek feedback or coaching that improves my execution and performance.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q28. My goals and commitments are more likely to be completed because another person is aware of them and tracks progress with me.
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Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Q29. I believe something in my leadership or life needs to change if I want better results.
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Yes
Somewhat
No
Q30. I am willing to confront uncomfortable truths if that is what growth requires.
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Yes
Somewhat
No
Q31. I am open to investing time, effort, and support into meaningful change.
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Yes
Somewhat
No
Q32. If I found the right path forward, I would seriously consider acting on it.
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Yes
Somewhat
No