Client - Resilience Questionnaire

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Name* This field is required.

First Name

Last Name

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Email* This field is required.

example@example.com

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For each question, score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree. Be honest: understanding the specific areas in which you lack resilience will enable you to get the most of our 10-point booster plan.

1 - Strongly disagree

2 - Disagree

3 - Somewhat disagree

4 - Neutral

5 - Somewhat agree

6 - Agree

7 - Strongly agree

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1. I believe in my own abilities* This field is required. Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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2. Believing in myself helps me to overcome difficult times* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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3. I know that I succeed if I carry on * This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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4. I know how to reach my goals* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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5. No matter what happens, I always find a solution * This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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6. I am comfortable together with other persons* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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7. My future feels promising* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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8. I know what I can solve my personal problems* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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9. I am pleased with myself* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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10. I have realistic plans for the future* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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11. I completely trust my judgment and decisions* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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12. At hard times, I know that better times will come * This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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13. I am good at getting in touch with new people* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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14. I easily establish new friendships* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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15. It is easy for me to think of good conversational topics* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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16. I easily adjust to new social milieus* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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17. It is easy for me to make other people laugh* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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18. I enjoy being with other people* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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19. I know how to start a conversation* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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20. I easily laugh* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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21. It is important for me to be flexible in social circumstances* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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22. I experience good relations with both men and women* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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23. There are strong bonds in my family* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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24. I enjoy being with my family* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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25. In our family, we are loyal towards each other* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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26. In my family, we enjoy finding common activities * This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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27. Evan at difficult times my family keeps a positive outlook on the future* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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28. In my family, we have a common understanding of what’s important in life* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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29. There are few conflicts in my family* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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30. I have some close family friends/family members who really care about me* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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31. I have some friends/family members who back me up* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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32. I always have someone who can help me when needed* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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33. I have some close friends/family members who are good at encouraging me* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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34. I am quickly notified if some family members get into a crisis * This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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35. I can discuss personal matters with friends/family members* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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36. I have some close friends/family members who value my abilities * This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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37. I regularly keep in touch with my family* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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38. There are strong bonds between my friends* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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39. Rules and regular routines make my daily life easier* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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40. I keep up my daily routines even at difficult times* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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41. I prefer to plan my actions* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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42. I work best when I reach for a goal* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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43. I am good an organizing my time* This field is required.Score yourself between 1 and 7, where 1=strongly disagree and 7=strongly agree

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Total Score