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MINDSET ALIGN
COACHING
KLH Associates
Mindset Align Coaching
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Self-Assessment Worksheet
First name
Last name
I am confident that I can change my life for the better.
Yes
No
I feel there are periods in my life when I had to end an old way of behavior and begin a new way of behavior.
Yes
No
It is okay to feel uncomfortable when learning a new way to deal with an old problem.
Yes
No
It stresses me out when I feel confused about what to do in the future.
Yes
No
I have the ability to recognize a feeling as it's happening to me.
Yes
No
I have the ability to control my emotions and impulses and think before acting.
Yes
No
I have the ability to self-motivate, driven to achieve for the sake of achievement.
Yes
No
I have the abiity to motivate others in relationships.
Yes
No
I have the abiity to remain optimistic in the face of failure.
Yes
No
I have the abiity to consider others' feelings, especially when making decisions.
Yes
No
I have the abiity to manage relationships to move others in desired directions, allowing them to develop and shine.
Yes
No
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