Name               :
Email Address:
unstuck! Personal Foundation Assessment	Disagree	Somewhat Disagree	Somewhat Agree	Agree
I avoid self destructive habits such as smoking, excessive alcohol, extreme caffeine, etc.
I get regular eye, teeth, and medical checkups
I make daily health self-care a priority
I exercise regularly
I have a healthy body weight
I get adequate rest regularly
I eat healthy foods and avoid unhealthy foods
I believe in myself and I believe I can reach my goals
I get rid of energy drainers in my world
I use very positive conversations (self talk) with myself
I take daily mental breaks and yearly full vacations
I actively work to eliminate worry from my life
I regularly evaluate myself and seek feedback from others
I discipline myself to follow through on established goals
I actively seek ways to be grateful everyday
I see a higher purpose in my daily living
I think about spirituality
I meditate or pray regularly
I allow myself to dream big things
I value the present by not being stuck in the past or too focused on the future
I have sense of peace about life and the challenges it brings
My home and living space are structured to meet my needs
My office space allows me to function efficiently and effectively
My clothes and personal items are organized for ready access
I regularly arrive on time
My transportation is well maintained and well planned
My physical environment is inspiring and energizing
I get rid of unnecessary items in my environment
I have eliminated unhealthy relationships that drain my energy
I have a full complement of friends and acquaintances
I work hard to maintain amicable family relationships
I actively work to forgive those who have hurt me
I stand up for myself in a respectful manner
I have effective conversations that include truthful speaking and active listening
I tend to judge or destructively criticize others
I have the basic degrees and certifications needed for my profession
I have clear and defined career goals
I maintain a healthy work-life balance
I have a mentor that I go to in my own profession
I maintain an active professional network
I contribute to my local or national professional associations
I participate regularly in continuing education to stay current in my profession
I have 6-8 months living expenses in readily available cash
I have a plan to achieve my financial goals
I maintain a regular, reasonable budget that provides for my needs
I follow an effective method for paying bills regularly and on time
I maintain a healthy debt balance
I have catastrophic health care insurance coverage and life and possessions insurance
I have an up to date will and other personal papers