Fuller Life System™ Personal Healing Readiness Assessment

Fuller Life System™ Personal Healing Readiness Assessment

This educational, non-diagnostic assessment helps you reflect on your readiness to begin or deepen your healing journey. It does not replace evaluation, diagnosis, treatment, or emergency care from a licensed professional. If you are in immediate danger or thinking about harming yourself, call 911 or call/text 988 in the United States.
Participant Information
Full Name

First NameMiddle NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age Range
Preferred Contact Method
Informed Consent and Safety
Healing Readiness Statements
I recognize that past experiences may still affect my present life.

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5

1 is Strongly Disagree, 5 is Strongly Agree
I am willing to be honest with myself about painful experiences.

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5

1 is Strongly Disagree, 5 is Strongly Agree
I can identify at least some emotions connected to my past.

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5

1 is Strongly Disagree, 5 is Strongly Agree
I am willing to explore family patterns and generational influences.

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1 is Strongly Disagree, 5 is Strongly Agree
I accept that healing may take time.

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1 is Strongly Disagree, 5 is Strongly Agree
I am ready to take responsibility for choices I can control.

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1 is Strongly Disagree, 5 is Strongly Agree
I am willing to release shame and unhealthy self-blame.

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1 is Strongly Disagree, 5 is Strongly Agree
I am open to forgiving without excusing harmful behavior.

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1 is Strongly Disagree, 5 is Strongly Agree
I am willing to establish and maintain healthy boundaries.

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1 is Strongly Disagree, 5 is Strongly Agree
I can ask for help when I need it.

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1 is Strongly Disagree, 5 is Strongly Agree
I have at least one safe and supportive person or resource.

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1 is Strongly Disagree, 5 is Strongly Agree
I am open to counseling, coaching, pastoral care, or other appropriate support.

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1 is Strongly Disagree, 5 is Strongly Agree
I am willing to practice healthy coping skills.

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1 is Strongly Disagree, 5 is Strongly Agree
I can tolerate some discomfort while working through difficult emotions.

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1 is Strongly Disagree, 5 is Strongly Agree
I am willing to challenge negative beliefs about myself.

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1 is Strongly Disagree, 5 is Strongly Agree
I believe meaningful change is possible for me.

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1 is Strongly Disagree, 5 is Strongly Agree
I am willing to make healing a regular priority.

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1 is Strongly Disagree, 5 is Strongly Agree
I can commit time each week to reflection and workbook activities.

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1 is Strongly Disagree, 5 is Strongly Agree
I am willing to track my progress honestly.

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1 is Strongly Disagree, 5 is Strongly Agree
I can accept setbacks without giving up.

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1 is Strongly Disagree, 5 is Strongly Agree
I am ready to reduce contact with harmful influences when appropriate and safe.

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1 is Strongly Disagree, 5 is Strongly Agree
I am willing to replace destructive habits with healthier choices.

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1 is Strongly Disagree, 5 is Strongly Agree
My faith, values, or sense of purpose can support my healing.

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1 is Strongly Disagree, 5 is Strongly Agree
I can imagine a healthier future for myself.

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1 is Strongly Disagree, 5 is Strongly Agree
I am ready to take one concrete healing step within the next seven days.

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1 is Strongly Disagree, 5 is Strongly Agree
Current Readiness Ratings
Current motivation to heal

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0 is Not at all motivated, 10 is Extremely motivated
Confidence in ability to change

0

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0 is Not at all confident, 10 is Extremely confident
Current emotional safety

0

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0 is Not at all safe, 10 is Completely safe
Available support

0

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0 is No support available, 10 is Strong support available
Willingness to seek professional help if needed

0

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0 is Not willing, 10 is Completely willing
Open Reflection Questions
What do you most want to heal from?
What has prevented you from healing before?
What strengths have helped you survive?
Who or what can support you?
What is one healing step you will take in the next seven days?
What barriers may affect your healing right now?
Personal Healing Readiness Score
I consent to submit my responses and understand this assessment is not a diagnosis.
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Fuller Life System™ Personal Healing Readiness Assessment

Participant Information

Informed Consent and Safety

Healing Readiness Statements

Current Readiness Ratings

Open Reflection Questions