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LifeFx Self Assessment

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Step 1 of 9

11%

I'm Filling This Out for*

Myself

a Loved One

First Name*

Last Name*

Loved One's Full Name*

I have trouble switching from one activity to another.

Rarely

Sometimes

Often

Almost Always

Once my mind is made up, I will not change it.

Rarely

Sometimes

Often

Almost Always

It is easy for me to adjust when plans change.

Rarely

Sometimes

Often

Almost Always

I am easily overwhelmed.

Rarely

Sometimes

Often

Almost Always

When I feel angry I can easily calm myself.

Rarely

Sometimes

Often

Almost Always

I can recognize and name the emotion I am feeling.

Rarely

Sometimes

Often

Almost Always

It's challenging for me to prioritize tasks when I have a lot on my plate.

Rarely

Sometimes

Often

Almost Always

I regularly set goals and objectives to achieve my vision for my life.

Rarely

Sometimes

Often

Almost Always

I can accomplish tasks independently without requiring supervision or assistance.

Rarely

Sometimes

Often

Almost Always

I am confused about my learning style and how my brain works best.

Rarely

Sometimes

Often

Almost Always

I trust my instincts when making decisions.

Rarely

Sometimes

Often

Almost Always

I feel confident using the tools I have learned at LifeFx.

Rarely

Sometimes

Often

Almost Always

I misplace or lose track of my belongings.

Rarely

Sometimes

Often

Almost Always

People tell me I am disorganized.

Rarely

Sometimes

Often

Almost Always

I keep my space (house, car, workspace) neat and tidy.

Rarely

Sometimes

Often

Almost Always

I find it hard to stick to a routine.

Rarely

Sometimes

Often

Almost Always

I get overwhelmed by big projects that have a lot of steps.

Rarely

Sometimes

Often

Almost Always

When I have a list of tasks, I can easily choose which is most urgent and start there.

Rarely

Sometimes

Often

Almost Always

When given feedback I don't like, it is difficult for me to pause and think before reacting.

Rarely

Sometimes

Often

Almost Always

I rush through my work.

Rarely

Sometimes

Often

Almost Always

I am good at thinking before I say or do something.

Rarely

Sometimes

Often

Almost Always

I don't know what to say when people are upset or angry with me.

Rarely

Sometimes

Often

Almost Always

It is hard for me to ask for help.

Rarely

Sometimes

Often

Almost Always

I know what I need and I know how to ask for it.

Rarely

Sometimes

Often

Almost Always

When I feel overwhelmed it impacts my ability to do well.

Rarely

Sometimes

Often

Almost Always

I am good at managing my stress.

Rarely

Sometimes

Often

Almost Always

I can handle a lot of stress and still feel in control.

Rarely

Sometimes

Often

Almost Always

My mind tends to wander during conversations.

Rarely

Sometimes

Often

Almost Always

People tell me I need to pay attention or focus more.

Rarely

Sometimes

Often

Almost Always

I can stay focused on tasks that I do not like/do not want to do without getting distracted.

Rarely

Sometimes

Often

Almost Always

I have good ideas but I struggle to put those ideas into action.

Rarely

Sometimes

Often

Almost Always

I procrastinate my work.

Rarely

Sometimes

Often

Almost Always

I can easily start tasks that I am not excited about or do not want to do.

Rarely

Sometimes

Often

Almost Always

It takes me a long time to get ready for school, work or appointments.

Rarely

Sometimes

Often

Almost Always

I get so focused on what I'm doing that I lose track of time.

Rarely

Sometimes

Often

Almost Always

I arrive on time for school, work, or appointments.

Rarely

Sometimes

Often

Almost Always

When I am given a list of tasks or instructions that involve multiple steps, I find it difficult to remember all the steps.

Rarely

Sometimes

Often

Almost Always

I need to write things down or I will not remember.

Rarely

Sometimes

Often

Almost Always

I am great at remembering people's names when we first meet.

Rarely

Sometimes

Often

Almost Always

Survey Completed

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