The 5C Solution - Self Assessment

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Area Code

Phone Number

4

I have a clear and written plan for my life.* This field is required.

Yes

No

5

I have a clear and written plan for my business/career.* This field is required.

Yes

No

6

My stress level is very low.* This field is required.

Yes

No

7

I believe I can do anything with no negative thoughts.* This field is required.

Yes

No

8

I have never had any past trauma, drama or loss.* This field is required.

Yes

No

9

I have never gone through any major life change.* This field is required.

Yes

No

10

All of my relationships fill me with love and joy.* This field is required.

Yes

No

11

I am not fearful of anything.* This field is required.

Yes

No

12

I am completely happy with my accomplishments.

Yes

No

13

I understand my internal and external challenges and know how to overcome them.* This field is required.

Yes

No

14

Please verify that you are human* This field is required.