Frequency Assessment

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This form evaluates your frequency in five life areas. We will keep your responses confidential and use them to set up your personal improvement plan, identify your "lowest common denominators", and compare progress.

Which is true for you?

I am interested in an initial assessment and learning more about programs offered.

I've enrolled in a program and this is my first assessment.

I'm part way through a program and this is my mid-assessment.

I've completed a program and this is my post-assessment.

Rate the following areas on a scale of 1 - 10 based on the past month. 1 = Completely Dissatisfied 10 = Completely Satisfied *

	Level of Satisfaction
	1	2	3	4	5	6	7	8	9	10
Physical (Health, Diet, Exercise, Body Chemistry)	1	2	3	4	5	6	7	8	9	10
Mental/Emotional (Happiness, Stress, Mind-set)	1	2	3	4	5	6	7	8	9	10
Spiritual (Practices, Meditation, Religion, Values)	1	2	3	4	5	6	7	8	9	10
Personal (Self-care, Self-esteem, Interests/hobbies)	1	2	3	4	5	6	7	8	9	10
Relational (Significant Other, Parenting, Family)	1	2	3	4	5	6	7	8	9	10
Occupational/Financial (Job, Career, School, Money)	1	2	3	4	5	6	7	8	9	10
Social (Friends, Connections, Recreation, Belonging)	1	2	3	4	5	6	7	8	9	10

Physical Frequency - Please mark all items that are true for you at least half or more of the time based on the past month.

	Physical Frequency
	True
1. I deal with chronic disease.	True
2. I depend on medications, medical interventions or therapy on a regular basis to manage life.	True
3. I complain about my health, body or symptoms regularly.	True
4. I am fairly sedentary. I don’t exercise. I just move just as much as I have to.	True
5. My weight is problematic. I can’t seem to overcome food cravings even though I try.	True
6. I eat a typical American diet of processed foods, sugar and fairly high fat intake.	True
7. I wish I were healthier, but it seems aging and health issues are to be expected.	True
8. My health is average and I get sick as often as most people I know.	True
9. I am making progress in my health and fitness, but I have a ways to go	True
10. I have adopted healthy routines and make conscious choices for the most part.	True
11. I have health promoting thoughts and self-mastery with diet and exercise almost daily.	True
12. I utilize mind-body solutions and feel healthier now than I did years, even decades ago.	True
13. I’m well above average in my fitness, routines, and health habits	True
14. I’ve experienced miracles in my health, reversing aging and disease.	True

Mental/Emotional Frequency - Mark all items that are true for you half or more of the time based on the past month.

	Mental/Emotional Frequency
	True
1. I tend to get stuck in negative, dense emotions like guilt and shame	True
2. I find myself shutting down to stop feeling. I experience regular apathy.	True
3. I experience consuming fear and/or emotional pain	True
4. I often feel guilty, like I am not doing enough or can’t catch up to where I should be	True
5. I feel and express anger frequently. It may do a little more harm than good.	True
6. Strong emotions are a driving force that take a lot of my energy.	True
7. I am hard on myself, but it seems to keep me on track for the most part	True
8. I manage my emotions and feel my feelings. I am well-adjusted for the most part.	True
9. I am able to neutralize strong feelings and accept things I can’t change.	True
10. I experience more positive than negative emotions. I overcome struggles and challenges.	True
11. Emotions are a source of transformation in my life, it is an energy that works for me.	True
12. I quickly return to positive emotional states. I maintain consistent happiness.	True
13. I’m at peace most of the time and/or maintain a sense of self-love	True
14. I experience feelings of bliss and transcendence on a regular basis.	True

Spiritual Frequency - Mark all items that are true for you at least half or more of the time based on the past month.

	Spiritual Frequency
	True
1. I feel trapped and hopeless. I don’t know if life is worth living.	True
2. It seems my spirit is more dark than light.	True
3. I have negative feelings toward religion and/or authority figures that “represent” God	True
4. I have been accused of being self-centered or self-absorbed.	True
5. I don’t like to be told what’s right or how to live my life.	True
6. It seems I am about equal in dark and light traits. I’m no better or worse than average.	True
7. I am able to live the way I’ve been taught, but sometimes I wonder why I am doing it.	True
8. I am very dedicated to spiritual practices and stick with daily routines, such as prayer.	True
9. I’ve experienced a change of heart in some area of my life and turned things around	True
10. I am passionate about spiritual topics and seek wisdom and learning.	True
11. I have a great deal of faith and/or intuition that guides me daily.	True
12. I have a miracle mind-set, seeing the hand of God in my life regularly	True
13. I strive to be self-actualized, to focus on the big picture and my mission within it.	True
14. I have developed a sixth sense that is extra-ordinary and/or my Source is a constant companion.	True

Occupational/Financial Frequency - Mark items that are true for you half or more of the time based on the past month.

	Occupational/Financial Frequency
	True
1. I am or recently have been homeless and/or institutionalized	True
2. I am completely dependent on others or social systems of care	True
3. I deal with or have recently dealt with poverty, unemployment or severely strained finances	True
4. I’ve been the victim of financial set-backs or I’ve been taken advantage of by others	True
5. I can never seem to get ahead and/or feel burdened by debt.	True
6. I am unemployed or underemployed, but have resources that keep me afloat.	True
7. I live pay-check to pay-check. I don’t have much of a savings account.	True
8. I have an abundance of time, but I’m financially limited.	True
9. I have what I need financially, but my work/job is unfulfilling.	True
10. I have enough money, but very little time or energy.	True
11. I experience abundance in most areas of life.	True
12. I am unlimited by jobs, finances or paradigms.	True
13. My abundance allows me both freedom and the opportunity to support important causes.	True
14. I am a master of attraction. Good things come to me almost instantly.	True

Social/Relational Frequency - Please mark all items that are mostly true for you based on the past month.

	Social/Relational Frequency
	True
1. I am isolated and have almost no positive relationships	True
2. My support system is minimal. I feel emotionally alone.	True
3. I have social anxiety that gets in the way of life and relationships	True
4. I have trust issues and don’t let others get too close	True
5. I have several conflicts with friends or family that bother me regularly	True
6. It seems I am on a roller coaster in relationships with equal ups and downs	True
7. I have developed emotional closeness with a few trusted friends or family	True
8. I have a great deal of empathy and close connections with others	True
9. I have a strong level of consistency in my relationships with rare or quickly-resolved conflicts	True
10. I have a strong role as a positive influencer in relationships with family and friends.	True
11. Others come to me for support and wisdom in managing their lives.	True
12. I have excellent boundaries and positive give-and-receive in almost every relationship	True
13. I am an emotionally intelligent leader of a tribe, business, group, or family system	True
14. I have a measurable social impact on communities, hundreds or even thousands of people	True

Thank you! Upon clicking "Submit" you should see an invitation to join our High-Frequency Community. Then check your email to schedule a private follow-up and receive your Frequency Scores.