Self Esteem Survey

* 1. First Name:

* 2. Last Name:

* 5. I feel that I’m a person of worth, at least equal to others.

* 6. I feel that I have a number of good qualities.

* 7. All in all, I am inclined to feel that I’m a failure.

* 8. I am able to do things as well as most other people.

* 9. I feel I do not have much to be proud of.

* 10. I take a positive attitude toward myself.

* 11. On the whole, I am satisfied with myself

* 12. I certainly feel useless at times.

* 13. At times, I think that I am no good at all.