Name *

First Name

Last Name

1. I have high standards for myself in almost every area of my life.

0 - Not True at All

1 - Somewhat True

2 - Mostly True

3 - Very True

2. I often worry about making mistakes or not meeting expectations.

0 - Not True at All

1 - Somewhat True

2 - Mostly True

3 - Very True

3. I rewrite, recheck, or overprepare even for simple tasks.

0 - Not True at All

1 - Somewhat True

2 - Mostly True

3 - Very True

4. I feel guilty when I rest, especially if I haven’t finished everything.

0 - Not True at All

1 - Somewhat True

2 - Mostly True

3 - Very True

5. I rarely celebrate my accomplishments before moving on to the next goal.

0 - Not True at All

1 - Somewhat True

2 - Mostly True

3 - Very True

6. I avoid starting things if I’m not sure I’ll succeed.

0 - Not True at All

1 - Somewhat True

2 - Mostly True

3 - Very True

7. I worry that others will see me as a failure if I don’t do something perfectly.

0 - Not True at All

1 - Somewhat True

2 - Mostly True

3 - Very True

8. I struggle to ask for help or delegate, even when overwhelmed.

0 - Not True at All

1 - Somewhat True

2 - Mostly True

3 - Very True

9. I criticize myself more than I praise myself.

0 - Not True at All

1 - Somewhat True

2 - Mostly True

3 - Very True

10. I feel like I’m constantly performing even when no one’s watching.

0 - Not True at All

1 - Somewhat True

2 - Mostly True

3 - Very True