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*Baseline Assessment

You can't adjust what you can't see. This assessment will help you visualize where you're going. You will get to know yourself and your desires better on a personal and professional level. So let's get started.

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Question 1 of 38

Full Name

Question 2 of 38

What is your relationship status?

A

Single

B

In relationship

C

Married

D

Other relationship type

Question 3 of 38

Describe your current home life in 150 words. Tell your SelfSync Therapist about your home and who makes up your immediate family. 

Question 4 of 38

Do you have any religious or spiritual practices? If so, tell your SelfSync Therapist about them.

Question 5 of 38

What is going well in your personal life?

Question 6 of 38

What is going well in your professional life?

Question 7 of 38

What challenges are you experiencing in your professional life?

Question 8 of 38

What challenges are you experiencing in your personal life?

Question 9 of 38

What kind of work do you do? 

Question 10 of 38

Do you feel the work you are doing is your purpose in life? If not, what is? If so, tell me more about this purpose?

Question 11 of 38

What's your idea of the Presidential Lifestyle. This time you can really explain. Include wealth, health, excitement, love and legacy desires.

I'M GLAD WE'RE HAVING THIS CONVERSATION!

THIS NEXT SECTION WILL HELP US DETERMINE HOW CLOSE OR FAR YOU ARE FROM YOUR IDEA OF THE PRESIDENTIAL LIFESTYLE.

Rate your level of satisfaction on a scale from 1-3 in each area. (1-lowest and 3-highest)

1-dissatisfied

2-somewhat satisfied

3-satisfied

Question 14 of 38

How satisfied are you with your business or professional life?

A

1 - Dissatisfied

B

2 - Somewhat Satisfied

C

3 - Satisfied

Question 15 of 38

How satisfied are you with the amount of leisure and selfcare time you have?

A

1 - Dissatisfied

B

2 - Somewhat satisfied

C

3 - Satisfied

Question 16 of 38

How satisfied are you with your romantic love life?

A

1 - Dissatisfied

B

2 - Somewhat Satisfied

C

3 - Satisfied

Question 17 of 38

How satisfied are you with your friendship and non-family relationships?

A

1 - Dissatisfied

B

2 - Somewhat satisfied

C

3 - Satisfied

Question 18 of 38

How satisfied are you with the your family relationships? (This relates to your family outside of your home.)

A

1 - Dissatisfied

B

2 - Somewhat satisfied

C

3 - Satisfied

Question 19 of 38

How satisfied are you with the relationship with your parents?

A

1-Dissatisfied

B

2-Somewhat Satisfied

C

3-Satisfied

D

N/A

Question 20 of 38

How satisfied are you with the community around you?

A

1 - Dissatisfied

B

2 - Somewhat Satisfied

C

3 - Satisfied

Question 21 of 38

How satisfied are you with the relationship with your children?

A

1-Dissatisfied

B

2-Somewhat Satisfied

C

3-Satisfied

D

N/A

Question 22 of 38

How satisfied are you with the quality of sleep you are currently getting?

A

1 - Dissatisfied

B

2 - Somewhat Satisfied

C

3 - Satisfied

Question 23 of 38

How satisfied are you with the quality of nutrition you are currently getting? 

A

1 - Dissatisfied

B

2 - Somewhat Satisfied

C

3 - Satisfied

Question 24 of 38

How satisfied are you with the quality of exercise/physical activity you are currently getting?

A

1 - Dissatisfied

B

2 - Somewhat Satisfied

C

3 - Satisfied

Question 25 of 38

How satisfied are you with the quality of stress and anger management you are currently getting?

A

1 - Dissatisfied

B

2 - Somewhat Satisfied

C

3 - Satisfied

Question 26 of 38

How satisfied are you with the quality of your overall health? 

A

1 - Dissatisfied

B

2 - Somewhat Satisfied

C

3 - Satisfied

Question 27 of 38

How satisfied are you with the quality of spirituality/religion you are currently getting?

A

1 - Dissatisfied

B

2 - Somewhat Satisfied

C

3 - Satisfied

Question 28 of 38

How satisfied are you with the quality of fun/adventure you are currently getting?

A

1 - Dissatisfied

B

2 - Somewhat Satisfied

C

3 - Satisfied

Question 29 of 38

How satisfied are you with the quality of creativity you are currently getting?

A

1 - Dissatisfied

B

2 - Somewhat Satisfied

C

3 - Satisfied

Question 30 of 38

How satisfied are you with the amount of revenue in your business? (This could be different than what you pay yourself if you own a business.)

A

1 - Dissatisfied

B

2 - Somewhat Satisfied

C

3 - Satisfied

D

N/A

Question 31 of 38

How satisfied are you with the amount of personal income in your life? (This can include both yours and a partner if you like.)

A

1-Dissatisfied

B

2-Somewhat Satisfied

C

3-Satisfied

Question 32 of 38

How satisfied are you with how you are executing your life mission or purpose? 

A

1 - Dissatisfied

B

2 - Somewhat Satisfied

C

3 - Satisfied

Question 33 of 38

What is your current business revenue range?

A

Under $100,000

B

$100,000 - $500,000

C

$500,001 - $1,000,000

D

$1,000,001 - $3,000,000

E

$3,000,001 - $10,000,000

F

Above $10,000,000

Question 34 of 38

What is your current personal income range? 

A

Less than $100,000

B

$100,000 - $500,000

C

$500,001 - $1,000,000

D

$1,000,001 - $3,000,000

E

$3,000,001 - $10,000,000

F

Above $10,000,000

Question 35 of 38

Are there any insights that you'd like to journal about here now that you've had time to reflect on your personal and professional life?

LET'S WRAP UP THIS DISCUSSION.

Before we part I just want to say, no matter what your results are right now, you are in the right place to make a shift. You don't have to do it on your own. We are here for you. 

Question 37 of 38

How did you FIRST get introduced to SelfSync Therapy by Presidential Lifestyle?

A

A Trusted Advisor

B

Podcast

C

Heard Kiné speak live

D

Networking event

E

LinkedIn

F

YouTube

G

Instagram

H

Colleague

I

A friend or family member

J

Other

Question 38 of 38

We would greatly appreciate any details you could provide on how you heard about us. (including name of referral partner, podcast, friend, or other details), that way we can properly thank them. Thank you!

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