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1
Full Name
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First Name
Last Name
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2
Email
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example@example.com
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3
Phone Number
Area Code
Phone Number
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4
Are you tired of always wanting? Wanting your dream house? Wanting that car? Or, maybe even want financial freedom from your business?
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Yes, and I am ready to make a change.
Yes, but no matter how hard I work, I just don’t see how this is possible.
Yes, who doesn’t want that? The problem is how.
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5
Have you ever wondered why everyone else seems to have everything they ever dreamed of and MORE?
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I am lucky to have everything I ever wanted, I just want to get to the next level, and that is a big stretch for me.
Yes, all the time. I read all the books and join all the courses yet nothing seems to move the needle.
I have never been that lucky where everything just happens to me. I always have to struggle.
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6
Do you hold the belief that everything you desire in life is already within you?
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Yes, absolutely.
Sometimes, but I tend to doubt myself.
No, otherwise I would already have it.
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7
How do you feel about this statement? You can rearrange your thinking to be aligned with a higher concept of yourself and therefore attract everything you desire into your third-dimensional world.
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I know this to be true, but sometimes I just have to be reminded.
I have tried, but I can’t stop worrying about the reality of my life and the everyday issues I face.
What is the third dimension? I am not sure about this question.
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8
Decision-making is one of the most important skills for success. Finish this statement about your decision-making process.
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I make quick decisions, and I am confident in making them. They are driven by my intuition and belief that everything is always working out for me. OR I take my time making decisions, but once I have made up my mind I am confident in my decision.
My biggest setback is how much I procrastinate. I understand that this is limiting but I don’t have the luxury to make any wrong decisions.
Making decisions in my life is very hard, I weigh the pros and cons. It takes me a long time.
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9
Your self-concept is rooted in this question: “Who do I need to be in order to achieve the next level of myself?” Finish this statement.
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I am ready to live at the next level myself. Letting go of all fear and knowing that I am guided by love.
I want to live at the next level self, but I catch myself daily, triggered and discouraged by my reality.
I am not sure who my next level self is, I just know I can’t keep living the way I have been for years.
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10
Who is your current self? How do you define yourself right now?
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I am a successful business owner that has big dreams and is ready to make them happen OR I am tired of my corporate life and ready to live my purpose and fulfill my dreams.
I am a stay-at-home mom who wants to be her best self and set an example of excellence for my children.
I am in between jobs and tired of living day-to-day paycheck to paycheck. I know I have a bigger life to live.
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11
Assessment Score
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12
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