Thee Self-Care Quiz
These questions are designed to extract your personal perspective of yourself. Your goals, frustrations, position and trajectory. This quiz is not a form of diagnosis nor will your information be shared publicly. We take your confidentiality seriously and will do our absolute best to protect what you share. In the event we want to use your information for public knowledge, we will ask for your permission and state the reason of use. We use our data to enhance our services and improve our client-partner agreements. We do not advise, nor do we offer professional diagnose. If you are in a crisis or you need medical help, please call your local emergency authorities. We do not claim to protect or be held liable for issues that arise from a lack of mental awareness. If you are experiencing a crisis, seek help from a professional as soon as possible. 
Sign in to Google to save your progress. Learn more
Email *
What is the ONE big Vision you have for yourself? *
For example: To own a 6 figure company, be happily married, and travel every quarter
7 points
On a scale of 1-10, How much do you believe in yourself to accomplish your vision? *
1 = I'll never accomplish 
10 = I will accomplish
This question measures your belief system. Be honest, there is no judgment, only improvement.
7 points
Never accomplish
Will accomplish
When was the last time you spent intentional alone time? *
This question is designed to extract how you spend your time.
7 points
How often do you look at yourself in the mirror and say "I love you"  *
This question extracts a self-love perspective
7 points
Do you get frustrated with yourself often and secretly desire to live another persons' life? *
This question is designed to extract a self-appreciation perspective
7 points
How do you most often speak to yourself? *
This question is designed to extract a self-compassion perspective. 
7 points
What is your fear or fears? *
This question is designed to extract self-exploration activities or lack thereof. 
7 points
What is your major dislike with yourself? *
This question is designed to extract self-discovery activities or the lack thereof.
7 points
Write down a worthiness statement. (For example: No matter how many people leave me, I am worthy of being kept.)  *
This questions is designed to extract a personal self-worthiness perspective.
7 points
What is the level of confidence you have in yourself to create the successful life in your vision?  *
This question is designed to extract a personal self-confidence perspective.
7 points
No confidence
Extremely confident
What leaders influence you? (For example: Ashley Kirkwood)  *
This question is designed to extract who influences you in the leadership space.
7 points
Define success *
People typically don't have a personal definition of success. They take on others' definition. 
7 points
If you don't shift your perspective of your power in the next 6 months, what will happen? *
This question is designed to help you "connect the dots".
7 points
Do you practice setting and adhering to boundaries that protect you? *
This question is designed to gage a perspective on healthy boundaries or lack thereof. 
7 points
Would you like to receive more tips about Self-Care by becoming a member of my email list? *
0 points
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Inspired Bosses. Report Abuse
Google Forms