90-Minute Clarity Coaching Package - Anna Davis Coaching

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Duration: 90 minutes
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For each of the following items, please take a moment to evaluate on a scale of 0 to 5, where 0=definitely need to work on, please help! and 5=don't need to work on right now, where you are at with needing to work on and wanting support in/with the following things...

Please use the following rule of thumb:
5 is I'm doing awesome here, couldn't ask for more!
4 is I'm doing great, no complaints!
3 is I'm doing okay, though could be better
2 is I'm kinda rough or lacking this area
1 is a straight up problem
0 is gah, total failure!

Area of Life
Score
Using my time effectively {"type":"radio","name":"family","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on family","options":"0\n1\n2\n3\n4\n5"}

Establishing routines and good habits {"type":"radio","name":"fitness","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on fitness","options":"0\n1\n2\n3\n4\n5"}

Organizing school or work {"type":"radio","name":"fitness","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on fitness","options":"0\n1\n2\n3\n4\n5"}

Organizing personal space {"type":"radio","name":"work","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on work","options":"0\n1\n2\n3\n4\n5"}

Getting to meetings or appointments on time {"type":"radio","name":"work","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on work","options":"0\n1\n2\n3\n4\n5"}

Studying/Working
 {"type":"radio","name":"prosperity","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Scheduling
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Paying attention in meetings
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Managing long-term assignments
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Planning and prioritizing
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Making decisions and solving problems
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Keeping track of things
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Doing laundry
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Exercising
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Eating healthfully
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Waking up and staying up
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Getting to bed
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Taking medication
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Making friends
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Keeping friends
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Getting along in group situations
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Getting along with roommates
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Decreasing negative self-talk
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Managing stress and anxiety
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Establishing realistic goals
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Understanding my ADHD
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Explaining ADHD to teachers/employers
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Figuring out the next step in my life or career/job.
 {"type":"radio","name":"purpose","width":15,"value":"","size":"Normal","validation":"C1","validationMessage":"Please rate on purpose","options":"0\n1\n2\n3\n4\n5"}

Totals/Average:  
 {"type":"computed","name":"totalScore","width":20,"value":"","size":"Normal","validation":null,"validationMessage":null,"formula":"family+fitness+work+prosperity+purpose","hidden":false}

 or %{"type":"computed","name":"percentageAwesome","width":20,"value":"","size":"Jumbo","validation":null,"validationMessage":null,"formula":"(totalScore/25)*100","hidden":false}

 of awesome


Comments:
{"type":"textarea","name":"overallComments","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":170,"placeholder":"Optional, but hopefully you have some sentiments to share for the record!"}



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