Self Evaluation Questionnaire
WITHIN REACH Self-Evaluation Questionnaire: Where Are You?
Please circle your answer.
Y N 1. Do you struggle to have an accurate perspective of yourself or your situations?
Y N 2. Do you struggle with sadness, apathy, or despair?
Y N 3. Do you have low motivation?
Y N 4. Do you struggle to make meaningful relationships?
Y N 5. Do you worry or have difficulty with change?
Y N 6. Do your emotions often cause trouble for you or others?
Y N 7. Do you have habits that interfere with your functioning?
Y N 8. Do you have habits others want you to quit?
Y N 9. Do you have physical problems that worsen with stress or are difficult to diagnose?
Y N 10. Are you struggling to connect with God?
Y N 11. Do you struggle applying the Bible to your daily life situations and responses?
Y N 12. Do you dislike who you are?
Y N 13. Do you think your life has little or no purpose, significance, or meaning?
Y N 14. Do you struggle to forgive yourself or others?
Y N 15. Do you have trouble being assertive without being aggressive?
Y N 16. Do you struggle with conflict?
Y N 17. Do you want more out of life?
Y N 18. Do you think you aren’t achieving your potential?
Y N 19. Do you feel lost on your Journey?
Y N 20. Are you unsatisfied with your Journey?
Y N 21. Are you unsure of the destination of your Journey?
Y N 22. Are you lonely on your Journey?
Y N 23. Are you not sure why you are on your Journey?
Y N 24. Do you want a companion on your Journey?
Y N 25. Do you feel bogged down?
Y N 26. Do you feel trapped and unable to change your course or patterns?
Y N 27. Do you believe you are not free to be who God made you to be?
Y N 28. Is the life you desire hard to reach?
Y N 29. Is the life you desire Within Reach but you don’t know how to grab it?
Your total number of "yes" answers: _______
Your total number of "no" answers: ________
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