Pathway to Personal Clarity

First Name *

Last Name *

Phone *

Email *

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Do you currently make intentional efforts in your personal development? *

Yes

Not Sure

If yes, what do your personal efforts include? (check all that apply)

Books (physical/audio)

Courses (physical/digital)

Podcasts/Youtube/Etc

Personal Time (meditation/reflection/journaling)

Accountability (Group/1-on-1)

If yes, how much time per week do you dedicate to personal development?

0-1 hour

2-5 hours

6-10 hours

11+ hours

Have you created a personal purpose/mission statement? *

Yes

If yes, what is your purpose/mission statement?

Have you taken the time to identify your personal core values? *

Yes

If yes, what are your personal core values?

Do you feel supported by your organization or supervisor in your personal development? *

Yes

Not Sure

Do you feel supported by a spouse or close family member or friend in your personal development? *

Yes

Not Sure

What motivates you to engage in personal investment? (check all that apply) *

Confidence

Leadership Skills

Career Growth

Personal Affirmation

Other

What are the strengths that you recognize in yourself? *

What personal development topics are most important to you right now? (check all that apply) *

Time Management

Emotional Intelligence

Communication Skills

Goal Setting

Grit/Resilience

Confidence

Humility

Agency

Courage

What barriers are currently limiting your personal growth? *

If you could design the ideal personal development program, what would it include? *

What would you like to focus on and improve immediately? *

What progress would you like to see over the long-term? *

What would having more personal clarity allow you to do or become? *