First Name *

Last Name *

Email *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

1. I am able to acknowledge and process my emotions without feeling overwhelmed or reactive. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

2. I navigate difficult conversations with emotional control and empathy. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

3. I feel emotionally resilient, even during times of stress or uncertainty. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

4. I maintain clarity and focus throughout my day without constant distraction. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

5. I have a strong sense of purpose and direction that drives my daily choices. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

6. I can reframe negative thoughts and stay mentally grounded under pressure. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

7. I consistently care for my body through nutrition, movement, and rest. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

8. I feel energized, vital, and physically capable most days. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

9. I listen to my body’s needs and make choices that support long-term wellness. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

10. I feel connected to something greater than myself that gives my life meaning. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

11. I make time for stillness, reflection, or spiritual practice regularly. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

12. I trust my intuition and inner guidance in making important life decisions. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

13. I experience moments of expanded awareness, flow, or deep presence. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

14. I believe my life is part of a larger purpose or collective evolution. *

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On a scale from 1 to 5, how true is this for you?

Scale:
1 = Rarely True
2 = Occasionally True
3 = Sometimes True
4 = Often True
5 = Always True

15. I am open to non-ordinary ways of knowing and being (e.g., synchronicity, inner knowing, higher consciousness). *

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