CHPC Intake Page

Marital Status

Single

Married

Partnered

Divorced

Other or N/A

1. Clarity: Do you feel you are clear about who you are, your purpose, and the direction you want to go in life?

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2. Energy: Do you consistently have enough mental and physical energy needed to excel, accomplish your goals, and feel motivated and happy?

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3. Courage: Do you take action and consistently express who you truly are and what you truly think, need, and desire with the world?

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4. Productivity: Are you consistently focused and effective, and are you good at minimizing distractions and maintaining priorities?

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5. Influence: Do you feel you have the social influence with your family, friends, and team needed to accomplish your goals?

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