Energy Assessment Questionnaire

Where are you spending your energy? How are you showing up in each area of your life?
Please rate the statements honestly - not how things appear on the outside, but how you really feel on the inside.
Rate the following statements on a scale from 1 to 5. 1 = not at all true and 5 = completely true

I love my life. I’m doing everything I want to do and am living my passion.
Less True - 1 2 3 4 5 - More True
I feel loved, honored and respected in my personal relationship and I love, honor and respect my partner.
Less True - 1 2 3 4 5 - More True
My work is meaningful and fulfilling. I love what I do and the people I work with. I feel appreciated and respected.
Less True - 1 2 3 4 5 - More True
I am happy with my finances. I’m making the amount of money I want and deserve to be making and I have plenty to meet all my needs and more. I’m comfortable making, managing, thinking and talking about money.
Less True - 1 2 3 4 5 - More True
I love and appreciate my body. I am the weight that I want to be. I look and feel great. I take great care of myself.
Less True - 1 2 3 4 5 - More True
I am fit and healthy. I eat a healthy diet, and exercise regularly. I feel fit and strong. When I have health issues I do not ignore them, but I find the people who are able to help me.
Less True - 1 2 3 4 5 - More True
I regularly do things to nurture and support myself. I take time for myself whenever I need it. I know how to relax and have fun and I make sure I do this regularly.
Less True - 1 2 3 4 5 - More True
My family, including my children, parents and siblings, is loving and supportive. We have a great relationship.
Less True - 1 2 3 4 5 - More True
I have great friends. I am surrounded by people I love, admire and respect and who support me.
Less True - 1 2 3 4 5 - More True
I have high self-esteem. I am confident. I don’t worry about what other people think of me.
Less True - 1 2 3 4 5 - More True
I enjoy my home. Every room in my house is just as I want it to be. My home nurtures and supports me and the location is perfect.
Less True - 1 2 3 4 5 - More True
My home and work spaces are organized and free of clutter. I don’t feel the need to hold on to things that I no longer need, use, want or love.
Less True - 1 2 3 4 5 - More True
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