Assessment
Complete the Do I Love My Brain assessment to understand your current relationship with your brain across the 4 main brain health types: Biological, Psychological, Social, and spiritual.  
Meil *
Name *
Email *
Biological
To the best of your ability, please rate your personal assessment in how you feel for each of the below listed areas on a scale of 1-10.  

1- being a concern
5- being uncertain or average
10- excellent (I am a rock star!)
Brain Health *
1 punkt
Physical Health *
1 punkt
Nutrition (optimal balance of high nutrient foods) *
1 punkt
Regular exercise (at least 3-5 days a week) *
1 punkt
Sleep (regularly 7-9 hours of sleep/night) *
1 punkt
Hydration (at least 1/2 your body weight in water) *
1 punkt
Hormone Levels (balanced) *
1 punkt
Blood Sugar Levels *
1 punkt
Supplement Intake (take recommended nutrient dense supplements) *
1 punkt
Genetics (family history awareness & your actions for prevention of any future issues) *
1 punkt
Trauma/Injuries (management or improvement from) *
1 punkt
Allergen health *
1 punkt
Toxin Exposure (environmental like mold, use of drugs, excessive caffeine, alcohol, smoking) *
1 punkt
Infections (ability to treat or improve appropriately) *
1 punkt
Physical Illness (impacts to your ability to stay active) *
1 punkt
Medication (recommended dosage or excessive needs) *
1 punkt
Psychological
To the best of your ability, please rate your personal assessment in how you feel for each of the below listed areas on a scale of 1-10.  

1- being a concern
5- being uncertain or average
10- excellent (I am a rock star!)
Self Talk *
1 punkt
Self Concept *
1 punkt
Body Image *
1 punkt
Upbringing *
1 punkt
Development *
1 punkt
Past Emotional Trauma *
1 punkt
Past Successes *
1 punkt
Past Failures *
1 punkt
Sense of Worth *
1 punkt
Sense of Power or Control *
1 punkt
Generational Histories & Issues (immigrants, survivors of trauma, child or grandchild of alcoholics) *
1 punkt
Grief/Loss *
1 punkt
Hope *
1 punkt
Social
To the best of your ability, please rate your personal assessment in how you feel for each of the below listed areas on a scale of 1-10.  

1- being a concern
5- being uncertain or average
10- excellent (I am a rock star!)
Quality of Current Environment *
1 punkt
Sense of Connection (Family, Friends, and Community) *
1 punkt
Work And/Or School *
1 punkt
Relationships *
1 punkt
Stress *
1 punkt
Health *
1 punkt
Finances *
1 punkt
Current Successes or Failures (Socially) *
1 punkt
Information Intake *
1 punkt
Health Habits of Closest Family and Friends *
1 punkt
Spiritual
To the best of your ability, please rate your personal assessment in how you feel for each of the below listed areas on a scale of 1-10.  

1- being a concern
5- being uncertain or average
10- excellent (I am a rock star!)
Sense of Meaning & Purpose *
1 punkt
Why Does My Life Matter? *
1 punkt
Values *
1 punkt
Morality *
1 punkt
Accountability *
1 punkt
Connection To Past Generations *
1 punkt
Connection To Future Generations (i.e. Kids) *
1 punkt
Connection To Planet *
1 punkt
Connection To Higher Power *
1 punkt
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