Elevate

Assessment

Congratulations! This is the first step to transformation and elevating! The great thing about this assessment is that you can utilize it whether you decide to continue working with us or not. You will be emailed a copy of it and we recommend reflecting on your answers and seeing how you can start making changes. You can even use this when working with other coaches or therapists to help you on your journey. We recommend revisiting your assessment to track your progress and growth.

Please set aside some time for yourself to answer these questions honestly and thoroughly. Make sure you provide your email so you can get a copy. Thank you!

Simply,
Kerry & Team

First Name

Last Name

Address

Phone Number

Birthday

Profession

What are you struggling with? What is happening in your life to prompt you to reach out?

What are you currently doing in your life? What does a typical day look like?

If you are married or in a relationship please describe the relationship:

Do you have children? If so, list them and their ages

Describe your parents relationship. (both past and present) What did you and didn't you like?

Do you have siblings and how are those relationships?

What was your childhood like growing up?

What are some of your favorite and most painful memories?

What traumas have you experienced as a child, teen, and adult? Try to differentiate.

How have these traumas affected you now?

What fears do you have?

Describe your lifestyle

What does your spiritual life consist of currently and what would you want to add to this that you aren't doing right now?

What does your self care consist of currently and what would you want to add to this that you aren't doing right now?

What does your financial stability consist of currently and what would you want to add to this that you aren't doing right now?

What does your health habits consist of currently and what would you want to add to this that you aren't doing right now?

What do you do for fun now and what would you want to do for fun that you aren't doing right now?

What does your relationships and connection consist of currently and what would you want to add to this that you aren't doing right now?

Do you feel that you are aligned with your true self and purpose?

Are you aware of what your passions are and if yes, what are they?

Are you aware of what your unique gifts or talents are. If yes, what are they?

Where do you know you need improvements?

What have you done or tried before to work on making improvements?

What is calling you to want to work with me?

What do you want to accomplish?

What blocks or obstacles do you need to work through?

What do you want to get out of working with me?

Are you willing to be pushed and to put yourself first?

When you think of elevating, what does that look like to you?

What would optimal performance look like for you?

What dreams do you have that you want to follow?

If you didn’t have blocks or fears and had more time and money, what would you like to accomplish in your life?