Life Assessment

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Helping individuals find purpose and significance in their lives!

This assessment will quickly help you identify the areas in your life that need attention so you can begin making the positive changes in order to live the life you’re meant to live.

To make it as accurate as possible, please be open and honest with yourself. Keep in mind this is for you (to help you improve your life) and no one else.

Enjoy the process…you’re on the way to living the abundant life!

Privacy Agreement: I Chris Cucchiara will completely respect your privacy and keep the enclosed information and everything you discuss with me 100% confidential.

Contact Information

Name

Home Phone

Cell Phone

Begin Here

1) Are you waiting for the economy to turn around before you start that business you've always wanted?

2) Waiting for the right circumstances so you can go back to school and get the advanced degree you'd like to have?

3) Waiting for things to slow down at work (or for the children to get older) so you can write the book that's inside of you?

4) Waiting for the right circumstances before you do something about? (you may have more than one answer)

Examples: a) starting an exercise program b) weight-loss program c) spending more time with your spouse, children, and loved ones d) you get the idea!

Overall Quality

5) Rate the overall quality of your life in the following areas. (using a scale of 1 to 10, where 10 is the highest and 1 being the lowest) write your answer next to each question.

Health and Wellness

Relationships

Mental/emotional

Spiritual

Financial

Professional

Parenting

Overall happiness

6) If time and money wasn’t an issue in your life, what would you do?

7) What do you feel is holding you back from achieving your goals and dreams?

8) Have you developed a personal mission, vision,
or purpose statement?

Yes No

If so, what is it?

9) What are you doing to develop and maintain personal relationships?

10) What have you done or currently doing for personal development?

11) Are you currently earning what you’re worth?

Yes No

If not, what is your monthly income goal?

12) Are you willing to do “whatever it takes” to reach your life goals?
Yes No Maybe

13) Are you the type of person that likes to lead?
Yes No

14) Give me a few examples of where you have lead people before.

15) If you were truly living your Life Purpose and leading a movement for positive change in the world, how many people do you personally know that would lock arms with you and join your cause? These would be people you could call today, share your vision, and because of the relationship and respect you have for one another, they would immediately be part of your team.