Go quickly, your first response is your best.
Attention
1. Short term focus ...
is the ability to intensely lock your attention for a few moments on an event/task inside your head (thoughts, images) or outside your head (objects, people, etc.).
Rate your short term focus during REGULAR DAILY LIFE:
Attention
Short-term focus
Rest
Never able to intensely focus on targets
Laser-focused on the target every time
Rate your short term focus during stress/conflict/demand situations:
Attention
Short-term focus
Stress
Never able to intensely focus on targets
Laser-focused on the target every time
Attention
2. Sustained Attention ...
is the ability to maintain sufficient attention across a longer time period to perform or take in and process information (e.g. data input, attending to conversations, instructions, etc.)
Rate your ability to sustain attention during REGULAR DAILY LIFE:
Attention
Sustained Attention
Rest
Unable to sustain or keep focus
Excellent steel trap focus all the time
Rate your ability to sustain attention during stress/conflict/demand situations:
Attention
Sustained Attention
Stress
Unable to sustain or keep focus
Excellent steel trap focus all the time
Attention
3. Busy Brain ...
is busy thoughts or wandering mind interfering with your focus/performance
Rate how often you experience busy brain during REGULAR DAILY LIFE:
Busy brain always wandering / interfering
Busy brain never interferes, or even aids performance
Rate how often you experience busy brain during stress/conflict/demand situations:
Attention
Busy Brain
Stress
Busy brain always wandering / interfering
Busy brain never interferes, or even aids performance
Calm
4. Control
I feel/believe I have control over events and things that happen to me
Rate your sense of control over events during REGULAR DAILY LIFE:
Never feeling in control of events
Always feeling in control of events
Rate your sense of control over events during stress/conflict/demand situations:
Never feeling in control of events
Always feeling in control of events
Calm
5. Letting Go ...
is the ability to mentally let go of things that are not important to your health & performance
Rate your ability to mentally let go of things during REGULAR DAILY LIFE:
Never able to let go of things
Always able to let go of things
Rate your ability to mentally let go of things during stress/conflict/demand situations:
Never able to let go of things
Always able to let go of things
Calm
6. Anxiety / worry
Rate how often your anxiety/worry interferes with your health or performance during REGULAR DAILY LIFE:
Always interferes
Never interferes
Rate how often your anxiety/worry interferes during stress/conflict/demand situations:
Calm
Anxiety / worry
Stress
Always interferes
Never interferes
Calm
7. Negative thoughts / depression
Rate how often negative/depressive thoughts interfere with your health or performance during REGULAR DAILY LIFE:
Calm
Negative thoughts / depression
Rest
Always interferes
Never interferes
Rate how often negative/depressive thoughts interfere during stress/conflict/demand situations:
Calm
Negative thoughts / depression
Stress
Always interferes
Never interferes
Calm
8. Muscles
Rate how often unnecessarily tight muscles (or tremor) interfere with your health or performance during REGULAR DAILY LIFE:
Always interferes
Never interferes
Rate how often unnecessarily tight muscles (or tremor) interfere during stress/conflict/demand situations:
Always interferes
Never interferes
Calm
9. Breathing ...
where unnecessarily holding your breath, or breathing fast/erratically, interferes with your health and/or performance
Rate how often breathing interferes during REGULAR DAILY LIFE:
Always interferes
Never interferes
Rate how often breathing interferes during stress/conflict/demand situations:
Always interferes
Never interferes
Calm
10. Heart racing
Rate how often your heart is beating unnecessarily fast or erratically during REGULAR DAILY LIFE:
Always racing
Never racing
Rate how often your heart is beating unnecessarily fast or erratically during stress/conflict/demand situations:
Always racing
Never racing
Calm
11. Sweating ...
where your body/ hands unnecessarily sweat a lot(even when not doing physical activity or in a hot location)
Rate how often you are sweating unnecessarily during REGULAR DAILY LIFE:
Always sweating
Never sweating
Rate how often you are sweating unnecessarily during stress/conflict/demand situations:
Always sweating
Never sweating
Calm
12. Cold hands ...
where your hands are unnecessarily cold (even when not in a cold location)
Rate how often your hands are unnecessarily cold during REGULAR DAILY LIFE:
Always cold hands
Never cold hands
Rate how often your hands are unnecessarily cold during stress/conflict/demand situations:
Always Cold hands
Never Cold hands
Calm
13. Stomach knots
Rate how often your stomach is tight, upset or nauseous during REGULAR DAILY LIFE:
Always upset
Never upset
Rate how often your stomach is tight, upset or nauseous during stress/conflict/demand situations:
Always upset
Never upset
Ideal Performance/Zone
14. Preparation for Performing at Your Best ...
feeling you have an adequate preparation to perform at your best (eg. knowledge, lifestyle, fitness, training, experience, etc.)
Rate how prepared you feel to perform at your best during REGULAR DAILY LIFE:
Ideal Performance/Zone
Preparation for Performing at Your Best
Rest
Never feel adequately prepared
Always feel adequately prepared
Rate how prepared you feel to perform at your best during stress/conflict/demand situations:
Ideal Performance/Zone
Preparation for Performing at Your Best
Stress
Never feel adequately prepared
Always feel adequately prepared
Ideal Performance/Zone
15. Body State for Ideal Performance ...
is feeling that your body is at an ideal state to perform optimally in the current task
Rate how often your body is at an optimally performing state during REGULAR DAILY LIFE:
Ideal Performance/Zone
Body State for Ideal Performance
Rest
Never in an optimally performing state
Always in an optimally performing state
Rate how often your body is at an optimally performing state during stress/conflict/demand situations:
Ideal Performance/Zone
Body State for Ideal Performance
Stress
Never in an optimally performing state
Always in an optimally performing state
Ideal Performance/Zone
16. Mental State for Ideal Performance ...
is feeling that your mind is at an ideal state to perform optimally in the current task
Rate how often your mind is at an optimally performing state during REGULAR DAILY LIFE:
Ideal Performance/Zone
Mental State for Ideal Performance
Rest
Never in an optimally performing state
Always in an optimally performing state
Rate how often your mind is at an optimally performing state during stress/conflict/demand situations:
Ideal Performance/Zone
Mental State for Ideal Performance
Stress
Never in an optimally performing state
Always in an optimally performing state
Ideal Performance/Zone
17. Grit ...
is the ability to stay focused/committed to performing at your best even when things are going poorly or the outcome seems bleak
Rate your grit during REGULAR DAILY LIFE:
Ideal Performance/Zone
Grit
Rest
Never have grit
Always have grit
Rate your grit during stress/conflict/demand situations:
Ideal Performance/Zone
Grit
Stress
Never have grit
Always have grit
Ideal Performance/Zone
18. Resilience ...
is how well you recover or adapt to changes or adversity
Rate your resilience during REGULAR DAILY LIFE:
Ideal Performance/Zone
Resilience
Rest
Never Resilient
Always Resilient
Rate your resilience during stress/conflict/demand situations:
Ideal Performance/Zone
Resilience
Stress
Never Resilient
Always Resilient
Sleep
19. Time to fall asleep
Rate how long it takes to fall asleep during REGULAR DAILY LIFE:
Sleep
Time to fall asleep
Rest
Never asleep within 30 minutes
Always asleep within 30 minutes
Rate how long it takes to fall asleep during stress/conflict/demanding periods of life:
Sleep
Time to fall asleep
Stress
Never asleep within 30 minutes
Always asleep within 30 minutes
Sleep
20. Night awakenings
Rate how easy it is to fall back to sleep within 30 minutes during REGULAR DAILY LIFE:
Sleep
Night awakenings
Rest
Never fall back to sleep within 30 minutes
Always fall back to sleep within 30 minutes
Rate how easy it is to fall back to sleep within 30 minutes during stress/conflict/demanding periods of life:
Sleep
Night awakenings
Stress
Never fall back to sleep within 30 minutes
Always fall back to sleep within 30 minutes
Sleep
Rate the impact of your sleep quality during REGULAR DAILY LIFE:
Fatigued all of the time even if sufficient hours of sleep
Feeling rested, sharp, ready, due to good sleep
Rate the impact of your sleep quality during stress/conflict/demanding periods of life:
Sleep
Impact of Sleep
Stress
Fatigued all of the time even if sufficient hours of sleep
Feeling rested, sharp, ready, due to good sleep
Behaviour
22. Sufficient, Balanced, Healthy Nutrition
Rate how often you maintain a sufficient, balanced, healthy diet during REGULAR DAILY LIFE:
Behaviour
Sufficient, Balanced, Healthy Nutrition
Rest
Never eat a sufficient, balanced, healthy diet
Always eat a sufficient, balanced, healthy diet
Rate how often you maintain a sufficient, balanced, healthy diet during stress/conflict/demand situations:
Behaviour
Sufficient, Balanced, Healthy Nutrition
Stress
Never eat a sufficient, balanced, healthy diet
Always eat a sufficient, balanced, healthy diet
Behaviour
23. Use of alcohol, drugs, nicotine (tobacco, vapes, etc.)
Rate how often you use tobacco/alcohol/drugs during REGULAR DAILY LIFE:
Behaviour
Use of alcohol, drugs, and nicotine
Rest
Multiple times every day
Never
Rate how often you use tobacco/alcohol/drugs during stress/conflict/demand situations:
Behaviour
Use of alcohol, drugs, and nicotine
Stress
Multiple times every day
Never
Behaviour
24. Discipline to maintain behaviours and habits
Rate your discipline during REGULAR DAILY LIFE:
Behaviour
Discipline to maintain behaviours and habits
Rest
Never maintain discipline
Always disciplined
Rate your discipline during stress/conflict/demand situations:
Behaviour
Discipline to maintain behaviours and habits
Stress
Never maintain discipline
Always disciplined
Behaviour
25. Firm Belief
Rate your sense of firmly believing in yourself, or something outside yourself, during REGULAR DAILY LIFE:
Never firmly believe
Always firmly believe
Rate your sense of firmly believing in yourself, or something outside yourself, during stress/conflict/demand situations:
Never firmly believe
Always firmly believe
Behaviour
26. Commitment
Rate your sense of firm commitment to something/someone during REGULAR DAILY LIFE:
Never firmly committed
Always firmly committed
Rate your sense of firm commitment to something/someone during stress/conflict/demand situations:
Never firmly committed
Always firmly committed
Behaviour
27. Self-compassion ...
is showing compassion to yourself; being kind and understanding when you make mistakes or fail, acknowledging it is part of being human
Rate how often you practice self-compassion during REGULAR DAILY LIFE:
Belief
Self-compassion
Rest
Never practice self-compassion
Always practice self-compassion
Rate how often you practice self-compassion during stress/conflict/demand situations:
Belief
Self-compassion
Stress
Never practice self-compassion
Always practice self-compassion
Behaviour
28. Social support / cooperation ...
is having a social network in which you confide and cooperate
Rate your sense of social support/cooperation during REGULAR DAILY LIFE:
Belief
Social support / cooperation
Rest
I have no social support
I have very strong social support
Rate your sense of social support/cooperation during stress/conflict/demand situations:
Belief
Social support / cooperation
Stress
I have no social support
I have very strong social support
Behaviour
29. Problem solving
Rate your use of effective problem solving skills during REGULAR DAILY LIFE:
Belief
Problem solving
Rest
Never use effective problem solving skills
Always use effective problem solving skills
Rate your use of effective problem solving skills during stress/conflict/demand situations:
Belief
Problem solving
Stress
Never use effective problem solving skills
Always use effective problem solving skills
One more question with our thanks
30. What areas of improvement would most benefit your health and performance?
From the items below, choose only your TOP 3 answers. Click the #1 beside your first choice. Click the #2 beside your second choice. Click the #3 beside your third choice.:
Reducing negative thoughts, racing brain, or brain freezes
Improving attention, focus, or re-focus
Improving cognitive performance (decision making, reaction time, memory)
Improving physical performance
Decreasing stress symptoms on the body (headache, pain, tight muscles, gastrointestinal upset)
Improving sleep
Other
Head Quarters: 210 – 221 Esplanade W, North Vancouver, BC V7M 3J3
Phone: (604) 220-8866 | 
Monday—Friday: 9:00 AM-7:30 PM
