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Respond to the statements below using the following scale: 5- Almost Always True, 4- Usually True, 3- Occasionally True, 2-Not Usually True, 1-Almost Never True
1. I generally believe everything's going to be OK, so I tend not to worry.
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
2. I face mistakes, disappointments & problems without self-judgement, blame or guilt.
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
3. I take consistent action, progressive steps to my goals, resulting in achievement, new goals & forward movement.
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
4. I make decisions quickly & confidently based on my own judgement in the moment.
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
5. I move plans, projects, tasks, ideas, etc., forward to execution and completion in a way that makes me feel satisfied and fulfilled.
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
6. I recognize & celebrate all of my progress no matter how small or incomplete.
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
7. I embrace challenges, obstacles and disappointments as opportunities to help me learn, grow, and get stronger.
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
8. When faced with difficulties, I focus more on "How?" as in "How can I get through/past/over this? VS "Why?" as in "Why Me/Now?"
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
9. I feel trust and pride in my ability & skill to DO things - actions, activities, tasks, etc. with a level of competence that feels good.
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
10. I FEEL, SEE, BELIEVE, EXHIBIT, EXUDE a strong sense of my own personal value regardless of my ability to achieve my goals.
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
11. I feel worthy & enough just for BE-ING alive, regardless of what, how much or how well I THINK I'm DO-ING related to my goals.
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
12. No matter what "HITS THE FAN", I am able to immediately control my emotions, focus with a clear and level head & stay above the fray & worry.
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
13. When I am triggered, I can keep my negative emotions & feelings linked only to THAT person/event without letting it upset & negatively impact other parts of my day or other people.
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
14. I easily LET GO of negative feelings quickly without dwelling on them.
*
Almost Never True
1
2
3
4
Almost Always True
5
1 is Almost Never True, 5 is Almost Always True
Total
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*
First Name
Last Name
Email
*
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Phone Number
*
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