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The Crucible Project - Impact Survey
The following questions ask about different areas of life that may be influenced by your retreat experience. Some changes happen quickly, while others unfold over months or years. Please answer based on what is true for you today.
*
1.
Since attending the retreat, to what extent do you agree with the following statements?
(Required.)
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
My relationship with God is stronger.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
I experience God as more loving, present, and engaged with me.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
I am more honest with God about my sin, wounds, desires, and fears.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
I am more willing to surrender my life to God.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
I am more engaged in prayer, Scripture, worship, or spiritual practices.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
*
2.
Since attending the retreat, to what extent do you agree with the following statements?
(Required.)
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
My marriage/significant relationship has improved.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more emotionally present with my spouse/significant other.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I take more responsibility for my impact in the relationship.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more honest and less defensive in conflict.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
My spouse/significant other would say they have seen positive change in me.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
3.
Have your loved ones (spouse/significant others, family, friends) mentioned any specific changes they have seen in you? If so, what have they noticed in you?
*
4.
Since attending the retreat, to what extent do you agree with the following statements?
(Required.)
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am a better parent because of the retreat.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more emotionally present with my children.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more patient and less reactive at home.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I repair more quickly when I hurt or disappoint my children.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
My children/family would say they have experienced positive change in me.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
5.
What, if anything has changed in the way you show up or interact with your children or family?
*
6.
Since attending the retreat, to what extent do you agree with the following statements?
(Required.)
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more engaged with my church.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more willing to be known by others in Christian community.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more likely to seek accountability, prayer, or discipleship.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more willing to serve or lead in my church/community.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I feel less isolated in my spiritual life.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
7.
How has the retreat affected your engagement with church or Christian community?
*
8.
Since attending the retreat, to what extent do you agree with the following statements?
(Required.)
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more aware of my emotions and what drives my behavior.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am less controlled by shame, fear, anger, or isolation.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I take more responsibility for my choices and impact on others
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more willing to tell the truth about myself.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more able to receive feedback without becoming defensive.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
9.
Because of the retreat, what is one way you are living differently as it relates to your emotions?
*
10.
Since attending the retreat, to what extent do you agree with the following statements?
(Required.)
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I have deeper, more authentic relationships because of the retreat.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am less isolated than I was before the retreat.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I have people in my life who know the real me.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more willing to ask for help and support.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I have continued relationships formed or strengthened through Crucible.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
*
11.
Since attending the retreat, to what extent do you agree with the following statements?
(Required.)
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I have greater clarity about who God made me to be.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am living with more courage, purpose, and intentionality.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more willing to use my gifts to bless others.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I am more engaged in serving, mentoring, leading, or discipling others.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
I have taken specific action because of what I discovered at the retreat.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
N/A
12.
What is the most significant change in your life because of the retreat?
13.
What would your spouse, family, friend, pastor, or counselor say has changed in you?