Your Rewired 4 Success POST-Assessment
You MUST enter the SAME Name & E-mail here that you did for your Pre-Assessment so we can link your Before & After Results for you!
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First Name *
Last Name *
Email *
1.  Prioritize these life areas in order of importance... (know this can change throughout your life). *
 Priority #1 for Your TOP current Focus, Down to #6 on your LOWEST focus
1
2
3
4
5
6
Health
Wealth
Relationships
Self Well-Being
Giving to Humans/Planet
Environment (where you live)
2a). [Regardless of your prioritizing above] Select an area that you did primarily focus on for the Rewired4Success Program *
2b). In that area, what specifically did you achieve? (i.e. the whole Sweet Spot Goal, more than it, chunks of it...) *
Be as specific as possible.
3. How long have you wanted to achieve better results in this area? *
How long has this desire existed for you?
4.  What %Percentage of the TIME do you Now believe you can achieve the goals you set? *
5. What feels like a doable and/or exciting ‘Sweet Spot’ Goal to achieve in the next 45-60days? *
6. What COULD you DO NOW to gain momentum on this goal? *
List the activities that could enable you to achieve this goal…
Part 2 - Current Inner Game Wiring
1.  Now in an Average day, what %Percentage (out of 100) of your Thoughts & Emotions are Negative (even mild)? *
2.  List at least THREE Blocks or Unsupportive Beliefs that you (began to) cleared during the program (e.g. “I’m not good enough”) *
3.  Now on a scale of 1 to 10, how much is your Happiness linked to Conditions? *
If conditions in my life are "negative/bad" I am unhappy.
Regardless of "negative" or "positive" things happening in my life I am happy.
4. [On Average] Now how many TIMES IN A DAY do you have negative emotional reactions? *
5.  ONLY RATE the following areas of life that you HAVE negative stories or reactions to Now.
I shake off the negative story/reaction and return to positive thoughts & emotions
2
3
4
5
6
7
8
9
I can't seem to shake the feeling no matter what I do
Family: 
Friends
Colleagues: 
Money: 
Livelihood/Work: 
School/Education: 
Physical Health: 
Mental/Emotional Health: 
Physical Safety: 
Spirituality: 
Retirement: 
Other: 
Clear selection
6.  Now how long do you hold on to negative stories, beliefs, reactions or emotions? *
Select all that are relevant...
Required
7.  Daily ‘Inner Game’ Rituals – Defined as habits that you now do every day (or close to) that support your positive mental attitude, ideally at the beginning & end of your day (e.g.  inspirational audios, meditation/prayer, movement/exercise...) *
Do you have consistent daily rituals to develop your attitude?
If so, approximately for how long each day?  
How much time do you spend on your daily success rituals...
5 min
15 min
30 min
60 min
90 min
120 min
Beginning of day
End of Day
Clear selection
If so, what are they?
List the activities you do for your success rituals in A.M. and P.M.
8.  Daily ‘Outer Game’ Success Habits – Defined as habits that you do now to optimize your performance, skills and success in your primary goal area. e.g. (Scheduling, Amount of calls to make, Resumes to send, Pushups, Sales to make, etc) *
Do you have consistent daily rituals to develop your skills and abilities?
If so, how many rituals do you use?
1
2-3
4-6
Daily Success Habits
Clear selection
If so, LIST WHAT they are and WHEN you do them...
If this Rewired4Success Program has met and/or exceeded your expectations; what components caused that? or If not, why not? *
What did or did not make this course well worth your investment...
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