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1. Self-Esteem | Self-Confidence | Honesty Needs Assessment Anonymous Survey

Anonymous Survey to help Dr. Susan Campbell and Personal Life Media create the perfect product for those who would like to improve their self-confidence.

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* 1. Please rate yourself. On a scale of 1-5, with 5 having the most and 1 having the least amount of each attribution below.

  1 2 3 4 5
How would you rate your self-esteem?
How would you rate your self-love?
How would you rate your self-confidence?
How would you rate your self-trust?

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* 2. If you rated yourself low on any of the above, would you be willing to spend 10 minutes per day for 2 or 3 weeks to change this for the better? If yes, why? If no, why not?

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* 3. If you could easily change one thing about yourself, what would that be?

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* 4. Please rate yourself. On a scale of 1-5, with 5 having the most and 1 having the least amount of each situation below.

  1 2 3 4 5
How much do you concern yourself with “what do people think of me?
How anxious are you in social situations?
How much do you think that your communication skills need improving?

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* 5. Do you consider yourself on a spiritual path?

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* 6. If you consider yourself on a spiritual path, do you think honesty/telling the truth is a key component of a spiritual practice?

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* 7. Do you think if you focused on improving your communication skills, your self-confidence would improve?

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* 8. Do you think if you focused on improving your communication skills, your self-esteem would improve?

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* 9. Would you be interested in being invited to a free teleseminar on the topic of "How to be a more skillful, confident communicator?"

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* 10. Would you be interested in being invited to a free teleseminar on the topic of “The seven statements necessary for relationship success?"

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* 11. Would you be interested in being invited to a free teleseminar on the topic of “How to deal with people who push your buttons?”

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* 12. Please rate yourself. On a scale of 1-5, with 5 being the most and 1 being the least.

  1 2 3 4 5
How good do you feel about your physical appearance?

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* 13. If you have concerns about your appearance, which of these things are of concern to you: (Check all that apply)

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* 14. How do you feel about your self-presentation/personality?

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* 15. If you have concerns about this, what are your main concerns? (Check all that apply)

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* 16. Please rate yourself. On a scale of 1-5, with 5 being the most and 1 being the least.

  1 2 3 4 5
Does how do you feel about your intelligence limit your self-esteem?
Does how you feel about your intelligence limit your self-confidence?

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* 17. In your view, what is the relationship between self-esteem and self-confidence?

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* 18. On a scale of 1-5, would you like to be more:

  1 2 3 4 5
Present, more in-the-moment?
Honest and real?
In touch with your feelings?
In touch with your wants?

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* 19. Is there anything you'd like to share with us about this survey, your self-confidence, your self-esteem or anything else you'd like us to know?

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