Objective Importance Percentage
   Low High  
 
1 2 3 4 5 6
 
Financial prosperity
%
Enjoy clientele
%
Fulfillment in career
%
Satisfying relationships with colleagues
%
Comfortable standard of living
%
Healthy body
%
Satisfying relationship with life partner
%
Satisfying relationship with children
%
Expanding personal development
%
Fulfilling leisure-time activities
%
Free from worry
%
Ability to make decisions
%
Ability to see solutions
%
Having fun
%
     
Others    
%
%
%
     
     
     
 
1.) What are your three greatest concerns at this time?
 
2.) Which of the above areas would you like to develop in the next year? How would you like it to look if you could have it exactly the way you want?
 
3.) How will you know you have fulfilled the above? How will you feel?
 
4.) What do you feel are the major obstacles standing in your way? (Please be specific)
 
5.) What is it costing you to not achieve the above?
 
6.) What else would you like to express?
 
Bonus: How did you hear about us?
 
 
 
 
 
 
 
 
 
 
 
 
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