LEADR ASSESSMENT TEMPLATE

When you’ve been carrying deep grief or long-term stress, it can be hard to tell if you’re healing—or just surviving.This short quiz will help you discover where you are on your path toward presence, peace, and restoration.Take a deep breath. Be honest with yourself. There are no wrong answers—only insight.

Name

First NameLast Name

Email

example@example.com

How do you feel when you wake up in the morning?*

Drained, like I didn’t sleep at all.Tired but able to push through.Neutral—some days are okay, others not so much.Grounded and ready to start the day.

When grief or stress hits, what’s your usual response?*

I shut down or disconnect completely.I stay busy to avoid thinking about it.I try to notice what I’m feeling but struggle to process it.I allow space to feel it and have ways to support myself.

How often do you feel truly present in your body and surroundings?*

Rarely, I often feel detached or numb.Occasionally, usually only during certain activities.Fairly often—I’m learning to notice when I disconnect.Most of the time—I feel grounded and aware.

Which best describes your energy levels during the day?*

I feel completely depleted, even with rest.I fluctuate between exhaustion and bursts of productivity.I have some steady energy, but burnout creeps in.I feel generally balance and know when to rest.

When was the last time you felt genuine joy or peace?*

I honestly can’t remember.It’s been a while, but I’ve had glimpses recently.I feel it in small ways, but it fades quickly.I experience it regularly, even in difficult seasons.

How do you currently care for yourself emotionally?*

I don’t really have the energy or time for self-care.I try, but it often feels forced or inconsistent.I have a few practices that help sometimes.I have regular routines that truly support me.

What’s your relationship with your body right now?*

I feel disconnected or critical toward it.I try to tune in, but I often ignore what it’s telling me.I’m learning to listen to it more.I feel in sync and trust its signals.

Which best describes your grief journey?*

It still feels raw, heavy, and all-consuming.I’ve learned to function, but it still feels unresolved.I’ve done some healing but feel “stuck” in certain areas.I’ve found meaning and can hold both pain and peace.

What have you tried so far to feel better?*

Nothing seems to work—I feel lost.I’ve tried therapy, journaling, or self-help, but I can’t stick with it.I’ve experimented with mindfulness or movement, with mixed results.I’ve found practices that help me feel grounded and want to go deeper.

How connected do you feel to your purpose or what matters most to you?*

Completely disconnected—I’m just surviving.I think about it often, but can’t feel it.I’m slowly reconnecting to what feels meaningful.I feel aligned and more intentional about how I live.

Calculation

Are You Surviving or Starting to Heal?