Emotional Health Assessment
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Nickname (what ever name you feel comfortable with) This will be the designation in the report you receive *
Who is your coach / counselor?
Email address (only required for clients of Coach Steve)
I would be quite bored by a visit to an art gallery.
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Strongly disagree
Strongly agree
I clean my office or home quite frequently.
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Strongly disagree
Strongly agree
I rarely hold a grudge, even against people who have badly wronged me.
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Strongly disagree
Strongly agree
I feel reasonably satisfied with myself overall.
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Strongly disagree
Strongly agree
I would feel afraid if I had to travel in bad weather conditions.
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Strongly disagree
Strongly agree
If I want something from a person I dislike, I will act very nicely toward that person in order to get it.
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Strongly disagree
Strongly agree
I'm interested in learning about the history and politics of other countries.
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Strongly disagree
Strongly agree
When working, I often set ambitious goals for myself.
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Strongly disagree
Strongly agree
People sometimes tell me that I am too critical of others.
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Strongly disagree
Strongly agree
I rarely express my opinions in group meetings.
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Strongly disagree
Strongly agree
I sometimes can't help worrying about little things.
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Strongly disagree
Strongly agree
If I knew that I could never get caught, I would be willing to steal a million dollars.
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Strongly disagree
Strongly agree
I would like a job that requires following a routine rather than being creative.
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Strongly disagree
Strongly agree
I often check my work over repeatedly to find any mistakes.
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Strongly disagree
Strongly agree
People sometimes tell me that I'm too stubborn.
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Strongly disagree
Strongly agree
I avoid making "small talk" with people.
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Strongly disagree
Strongly agree
When I suffer from a painful experience, I need someone to make me feel comfortable.
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Strongly disagree
Strongly agree
Having a lot of money is not especially important to me.
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Strongly disagree
Strongly agree
I think that paying attention to radical ideas is a waste of time.
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Strongly disagree
Strongly agree
I make decisions based on the feeling of the moment rather than on careful thought.
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Strongly disagree
Strongly agree
People think of me as someone who has a quick temper.
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Strongly disagree
Strongly agree
I am energetic nearly all the time.
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Strongly disagree
Strongly agree
I feel like crying when I see other people crying.
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Strongly disagree
Strongly agree
I am an ordinary person who is no better than others.
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Strongly disagree
Strongly agree
I wouldn't spend my time reading a book of poetry.
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Strongly disagree
Strongly agree
I plan ahead and organize things, to avoid scrambling at the last minute.
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Strongly disagree
Strongly agree
My attitude toward people who have treated me badly is "forgive and forget".
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Strongly disagree
Strongly agree
I think that most people like some aspects of my personality.
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Strongly disagree
Strongly agree
I don’t mind doing jobs that involve dangerous work.
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Strongly disagree
Strongly agree
I wouldn't use flattery to get a raise or promotion at work, even if I thought it would succeed.
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Strongly disagree
Strongly agree
I enjoy looking at maps of different places.
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Strongly disagree
Strongly agree
I often push myself very hard when trying to achieve a goal.
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Strongly disagree
Strongly agree
I generally accept people’s faults without complaining about them.
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Strongly disagree
Strongly agree
In social situations, I'm usually the one who makes the first move.
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Strongly disagree
Strongly agree
I worry a lot less than most people do.
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Strongly disagree
Strongly agree
I would be tempted to buy stolen property if I were financially tight.
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Strongly disagree
Strongly agree
I would enjoy creating a work of art, such as a novel, a song, or a painting.
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Strongly disagree
Strongly agree
When working on something, I don't pay much attention to small details.
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Strongly disagree
Strongly agree
I am usually quite flexible in my opinions when people disagree with me.
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Strongly disagree
Strongly agree
I enjoy having lots of people around to talk with.
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Strongly disagree
Strongly agree
I can handle difficult situations without needing emotional support from anyone else.
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Strongly disagree
Strongly agree
I would like to live in a very expensive, high-class neighborhood.
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Strongly disagree
Strongly agree
I like people who have unconventional views.
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Strongly disagree
Strongly agree
I make a lot of mistakes because I don't think before I act.
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Strongly disagree
Strongly agree
I rarely feel anger, even when people treat me quite badly.
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Strongly disagree
Strongly agree
On most days, I feel cheerful and optimistic.
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Strongly disagree
Strongly agree
When someone I know well is unhappy, I can almost feel that person's pain myself.
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Strongly disagree
Strongly agree
I wouldn’t want people to treat me as though I were superior to them.
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Strongly disagree
Strongly agree
If I had the opportunity, I would like to attend a classical music concert.
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Strongly disagree
Strongly agree
People often joke with me about the messiness of my room or desk.
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Strongly disagree
Strongly agree
If someone has cheated me once, I will always feel suspicious of that person.
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Strongly disagree
Strongly agree
I feel that I am an unpopular person.
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Strongly disagree
Strongly agree
When it comes to physical danger, I am very fearful.
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Strongly disagree
Strongly agree
If I want something from someone, I will laugh at that person's worst jokes.
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Strongly disagree
Strongly agree
I would be very bored by a book about the history of science and technology.
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Strongly disagree
Strongly agree
Often when I set a goal, I end up quitting without having reached it.
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Strongly disagree
Strongly agree
I tend to be lenient in judging other people.
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Strongly disagree
Strongly agree
When I'm in a group of people, I'm often the one who speaks on behalf of the group.
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Strongly disagree
Strongly agree
I rarely, if ever, have trouble sleeping due to stress or anxiety.
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Strongly disagree
Strongly agree
I would never accept a bribe, even if it were very large.
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Strongly disagree
Strongly agree
People have often told me that I have a good imagination.
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Strongly disagree
Strongly agree
I always try to be accurate in my work, even at the expense of time.
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Strongly disagree
Strongly agree
When people tell me that I’m wrong, my first reaction is to argue with them.
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Strongly disagree
Strongly agree
I prefer jobs that involve active social interaction to those that involve working alone.
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Strongly disagree
Strongly agree
Whenever I feel worried about something, I want to share my concern with another person.
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Strongly disagree
Strongly agree
I would like to be seen driving around in a very expensive car.
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Strongly disagree
Strongly agree
I think of myself as a somewhat eccentric person.
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Strongly disagree
Strongly agree
I don’t allow my impulses to govern my behavior.
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Strongly disagree
Strongly agree
Most people tend to get angry more quickly than I do.
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Strongly disagree
Strongly agree
People often tell me that I should try to cheer up.s
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Strongly disagree
Strongly agree
I feel strong emotions when someone close to me is going away for a long time.
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Strongly disagree
Strongly agree
I think that I am entitled to more respect than the average person is.
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Strongly disagree
Strongly agree
Sometimes I like to just watch the wind as it blows through the trees.
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Strongly disagree
Strongly agree
When working, I sometimes have difficulties due to being disorganized.
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Strongly disagree
Strongly agree
I find it hard to fully forgive someone who has done something mean to me.
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Strongly disagree
Strongly agree
I sometimes feel that I am a worthless person.
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Strongly disagree
Strongly agree
Even in an emergency I wouldn't feel like panicking.
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Strongly disagree
Strongly agree
I wouldn't pretend to like someone just to get that person to do favors for me.
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Strongly disagree
Strongly agree
I’ve never really enjoyed looking through an encyclopedia.
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Strongly disagree
Strongly agree
I do only the minimum amount of work needed to get by.
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Strongly disagree
Strongly agree
Even when people make a lot of mistakes, I rarely say anything negative.
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Strongly disagree
Strongly agree
I tend to feel quite self-conscious when speaking in front of a group of people.
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Strongly disagree
Strongly agree
I get very anxious when waiting to hear about an important decision.
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Strongly disagree
Strongly agree
I’d be tempted to use counterfeit money, if I were sure I could get away with it.
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Strongly disagree
Strongly agree
I don't think of myself as the artistic or creative type.
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Strongly disagree
Strongly agree
People often call me a perfectionist.
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Strongly disagree
Strongly agree
I find it hard to compromise with people when I really think I’m right.
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Strongly disagree
Strongly agree
The first thing that I always do in a new place is to make friends.
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Strongly disagree
Strongly agree
I rarely discuss my problems with other people.
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Strongly disagree
Strongly agree
I would get a lot of pleasure from owning expensive luxury goods.
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Strongly disagree
Strongly agree
I find it boring to discuss philosophy.
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Strongly disagree
Strongly agree
I prefer to do whatever comes to mind, rather than stick to a plan.
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Strongly disagree
Strongly agree
I find it hard to keep my temper when people insult me.
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Strongly disagree
Strongly agree
Most people are more upbeat and dynamic than I generally am.
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Strongly disagree
Strongly agree
I remain unemotional even in situations where most people get very sentimental.
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Strongly disagree
Strongly agree
I want people to know that I am an important person of high status.
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Strongly disagree
Strongly agree
I have sympathy for people who are less fortunate than I am.
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Strongly disagree
Strongly agree
I try to give generously to those in need.
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Strongly disagree
Strongly agree
It wouldn’t bother me to harm someone I didn’t like.
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Strongly disagree
Strongly agree
People see me as a hard-hearted person.
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Strongly disagree
Strongly agree
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