The Clarity Protocol – Men | Confidential Intake Assessment

THE CLARITY PROTOCOL – Men's Initial Assessment (CONFIDENTIAL)

This assessment helps us to identify patterns of nervous-system load, identity coherence, emotional processing, relational responsibility, and biological strain — this does not assess behaviours. This assessment helps us understand where you are in your current phase and provides meaningful context for our initial conversation, allowing it to be focused, relevant, and respectful of your time. Answer honestly. There are no “right” responses.
Privacy, Confidentiality & Professional Standards

Your responses are collected solely for assessment, intake, and program-matching purposes. All information is handled confidentially, stored securely, and accessed only by authorized personnel involved in program delivery and client support at Unity Institute & YouMattYr Foundation.

We adhere to the ethics, professional standards, and practice guidelines of the Academy of Naturopaths and Naturotherapists of Canada (ANNC). This assessment is educational and integrative in nature and does not replace medical diagnosis, mental health treatment, or emergency services.

Participation is voluntary. You may decline to answer any question.
Name*

First NameLast Name
Please Enter ONE Number Choice per question based on the following values:
Not true-1, Slightly true-2, Moderately true-3, Mostly true-4, Very true-5

SECTION 1 — INTERNAL LOAD & NERVOUS SYSTEM*

	VALUE 1-5
I stay productive even when mentally or physically exhausted.
I feel internally tense or “on edge” more often than fully settled.
My system struggles to fully shut down, even when rest is available.
I override physical signals to meet responsibility or expectations.
Calm feels conditional rather than automatic.

SECTION 2 — EMOTIONAL PROCESSING*

	VALUE 1-5
I compartmentalize emotions to stay effective.
Emotional pressure builds faster than it resolves.
I down-regulate emotion through control rather than expression.
Emotional signals show up as irritation, fatigue, or withdrawal.
I manage emotions internally rather than processing them outwardly.

SECTION 3 — IDENTITY & SELF-TRUST*

	VALUE 1-5
My confidence fluctuates based on performance or outcomes.
I feel pressure to prove competence, reliability, or control.
I struggle to separate identity from responsibility.
I second-guess decisions more than I outwardly show.
I measure self-worth by output rather than internal alignment.

SECTION 4 — RELATIONAL LOAD & RESPONSIBILITY*

	VALUE 1-5
I carry responsibility for others’ outcomes or stability.
I suppress personal needs to avoid conflict or disruption.
I default into problem-solving mode in relationships.
Relationships feel like responsibility more than restoration.
I rarely receive the level of support I provide.

SECTION 5 — BIOLOGICAL & RHYTHM STABILITY*

	VALUE 1-5
My energy output exceeds my recovery capacity.
Sleep quality directly impacts focus and tolerance.
Stress affects patience, mood, or decision-making.
I push through fatigue rather than adjusting pace.
Recovery feels incomplete or short-lived.

SECTION 6 — ALIGNMENT & READINESS*

	VALUE 1-5
I want clarity, not just stress management.
I’m ready to understand how my system adapted over time.
I value precision, privacy, and intelligence in personal work.
I’m open to addressing the nervous system, identity, and biology together.
I’m willing to restructure how I operate for long-term stability.

THE CLARITY PROTOCOL – Men's Initial Assessment (CONFIDENTIAL)