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Thank you for taking the time to complete this form before your Internal Capacity Assessment.
These questions give me some context for understanding what is happening in your life right now, what you would like to change, and what you have already tried. There are no right or wrong answers. You do not need to have everything figured out before we meet.


All information shared here and on the call is 100% confidential and will help me make our Capacity Conversation more focused and useful to you.

Preferred way to contact you*
Occupation or primary role*
How did you hear about the Internal Capacity Assessment?*
What prompted you to complete the Assessment at this point in your life?*
What feels most challenging, frustrating, or limiting for you right now? *
If things were meaningfully different six months from now, what would you most like to notice?*
Which of the following are affecting you right now? Select any that apply.*
If there are other factors affecting your experience right now, what are they?
Of the things you selected, which 1–3 are most important for us to understand?*
Where in your life do you currently feel most capable, supported, or like yourself?*
What practices, relationships, environments, or resources currently help you feel better, recover, or function well?*
What have you already tried to address the challenges that brought you here?*
What has helped, even a little?*
On a typical week, how much space do you feel you have for something unexpected?*
When life becomes more demanding, what tends to happen first for you?*
When you have been under stress, what helps you return to feeling more like yourself?*
Is there an area of your life where you know what would probably help, but find it difficult to consistently do or apply it?*
What would you most like to understand about yourself through this assessment?*
What would having greater internal capacity make possible for you?*
If you could leave this process with clarity about one thing, what would you want it to be?*
Are there any major changes, responsibilities, losses, transitions, or circumstances currently affecting your capacity that you would like me to know about?*
Is there anything else you think would be helpful for me to understand before our Capacity Conversation?*
The Internal Capacity Assessment is intended for education, self-understanding, and personal development. It is not intended to diagnose or treat a medical or mental health condition or replace care from an appropriately licensed healthcare professional. I understand the purpose and scope of the Internal Capacity Assessment.*

What Happens Next

After I receive your intake and assessment information, I will review your responses before our Capacity Conversation.

During our conversation, we'll explore the patterns that stand out, clarify what matters most to you, and identify where additional support may be most useful.

Following the assessment process, you'll receive personalized insight across the five domains of Internal Capacity, focused recommendations, and suggested next steps.