In order to best serve you...

Please complete this initial assessment designed to illuminate what’s currently impacting you and your life.

Name *
Name
Phone *
Phone
Personal Inventory
Personal Inventory
Indicate the degree to which you agree with the statements below.
1. I’m struggling after the loss of a relationship, finances, health, job or career, hopes, dreams, identity or world event.
2. I’m feeling stressed, overwhelmed or tired in my work or life.
3. I’m feeling the Sunday evening “blues”, anxiety or dread thinking about work Monday.
4. I find it difficult to set boundaries or say “no” to others at home or at work, in order to take care of myself.
5. I’m working to the point that it’s adversely affecting my physical health or personal life.
6. I’m feeling a lack of joy in my life.
7. I’ve been living a life that doesn’t reflect what I truly value, with my work, relationships, where I live or how I spend my time.
8. I don’t have a regular spiritual practice that quiets my mind and centers me, like meditation, prayer, walking in nature, etc..
9. I often make choices and decisions based on other’s opinions.
10. Even in my “closest” relationships, I don’t feel safe to fully be myself.
11. I’m not feeling as connected as I’d like in my most important relationships, including the one with myself.
12. I’m uncomfortable being alone without distracting myself.
13. I’ve been “successful” following “the rules” and “recipe” for life,  yet feel a void and hope there’s more.
14. I don’t really practice the faith tradition/belief system I grew up in, yet haven’t found a satisfying replacement.
15. I’d love more authentic, meaningful relationships, with myself, others, and my idea of a Higher Power.
16. I’ve had a recent wake-up call, and am now seeking more meaning and purpose in my life.
17. I’ve been neglecting one or more aspects of self-care: sleep, exercise, healthy eating or relaxation.
18. I rarely or never make time for creative pursuits or play.
19. If I died now, I’d have regrets.
20. I’d love to have more peace, freedom and joy in my life.