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THERAPY
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How Balance is your life?
Superwomen Audit
Choose which answer best fit you at this time.
1. You are working harder with less effectiveness?
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
2. Your child(ren) and/or partner complain about how grumpy you have become .
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
3. Most days you don’t feel very good about yourself.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
4. Have difficulties separating work and personal life.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
5. Experience guilt about all the things I am not doing.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
6. I have a hard time saying NO.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
7. I refuse to ask for help.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
8. I rather do it myself than to delegate to others.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
9. Experiencing relationship conflict with 2 or more people who are close to you.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
10. Consistently feeling behind schedule.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
11. Feel like running away.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
12. Feel overwhelmed and overextended.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
12. You feel powerless
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
14. You have stopped taking care of you.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
15. After a full night's rest, I still feel tired in the morning.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Tell me about you:
Name
*
First Name
Last Name
Email
*
DOB
MM
DD
YYYY
Send me Modern Mental Wellness Tips for Millennial Women .
*
YES Please
NO Thank you
Your Assessment is Complete and Your Results will be emailed to you momentarily.