child916 - MisterDmm

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Questionnaire Ages 9-16

1. How often do you check your thoughts? *

Always
Sometimes
Never

2. How often do you reflect on your thoughts? *

Always
Sometimes
Never

3. How much of your daily thinking is positive? *

4. How much of your daily thinking is negative? *

5. Did you wake up this morning with a positive or negative thought? *

Positive
Negative

6. Did this start a positive or negative momentum of thought? *

Positive
Negative

7. How many times per day will you deliberately change your thinking to affect your mood? *

8. How often each day do you think about your dreams and goals? *

Constantly
Occasionally
Never

9. How often do you use your imagination to play? *

10. What else do you use your imagination for? *

11. Describe your mood right now? *

12. How often each day do you check your mood? *

Always
Sometimes
Never

13. What do you do to try to improve your mood? *

14. Why is it important to be in a high mood state (good mood)? *

15. What bad habits do you have? *

16. What good habits do you have? *

17. What new habits are you trying to create? *

18. On your list of the people you love most, what number are you? *

19. What do you love about you? *

20. Have you found your Superstar? (what makes you special) *

Yes
No

21. What are doing to try to find it? *

22. Tell us about a thing you cannot do? *

23. Now tell us, WHO told you? *

24. Do you believe they were right? *

Yes
No

25. Have you tried to prove them wrong? *

Yes
No

26. What do you fear? *

27. What do you do when you feel scared? *

28. List the qualities your best self will have? *

29. Do you have these qualities now? *

Yes
No

30. Do you know how to develop these qualities? *

Yes
No

31. Do you know what your intuition is? *

Yes
No

32. Can you think of a time when you have used it? *

Name *

First

Last

Age *

Thank You!

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