The I AM Project – Intake Questionnaire

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Step 2 — Intake Questionnaire

The I AM Project Intake Questionnaire

Domain 1 of 7: Wellness 0%

Wellness

Physical + Mental

Sleep & recovery consistency

1. Sleep is chaotic; I pay the price regularly (energy/mood crashes). 2. I try, but stress or habits derail my sleep often. 3. Sleep is “okay” but inconsistent; I don’t protect it reliably. 4. Sleep is mostly protected; I recover well most nights. 5. Sleep is a non-negotiable; recovery is structured and dependable.

Nutrition stability

1. I eat reactively (cravings/impulse); it harms energy/mood. 2. I alternate between good intentions and poor execution. 3. I have some structure, but stress breaks it. 4. I eat with consistency; occasional slips don’t spiral. 5. I eat with discipline and planning; food supports performance.

Movement/training consistency

1. I’m sedentary or sporadic; training depends on motivation. 2. I start/stop; I miss often when life gets busy. 3. I’m somewhat consistent but not disciplined. 4. I train consistently; I keep commitments most weeks. 5. Training is identity-based; I follow through regardless of mood.

Stress regulation tools

1. I have few tools; I cope in ways that backfire (anger, shutdown, numbing). 2. I know tools but don’t use them reliably when stressed. 3. I use tools sometimes; results are mixed. 4. I regulate well most of the time; recovery is intentional. 5. I’m highly self-governed; stress triggers skill, not sabotage.

Self-sabotage behaviors (screens/sugar/alcohol/etc.)

1. Coping behaviors regularly run me and sabotage my health. 2. I reduce them sometimes, but stress pulls me back in. 3. I’m improving, but I still relapse into old coping patterns. 4. Mostly managed; occasional overuse doesn’t derail me. 5. Strong restraint; I choose regulation over numbing consistently.

Spirituality

Faith or Guiding Philosophy

Anchoring practice (prayer/reflection/study)

1. No consistent practice; I drift. 2. Sporadic practice; it disappears under pressure. 3. Some consistency; not deeply rooted. 4. Regular practice; it stabilizes me in hard weeks. 5. Daily/near-daily practice; it anchors identity and decisions.

Values/convictions clarity

1. I’m unclear or inconsistent; I’m driven by mood/approval. 2. I have beliefs, but they don’t guide choices reliably. 3. I’m forming clarity; I still compromise often. 4. Clear values; I usually act in alignment. 5. Strong moral clarity; decisions match convictions under stress.

Integrity under pressure

1. Under pressure, I betray my standards routinely. 2. I rationalize; integrity is inconsistent. 3. Mixed: sometimes strong, sometimes compromised. 4. Mostly intact; I course-correct quickly when I slip. 5. Durable integrity; pressure reveals character, not contradiction.

Humility/self-correction

1. I blame/avoid; I rarely own my part. 2. I admit faults sometimes, but defensiveness wins often. 3. I’m learning to own it; still inconsistent. 4. I take responsibility quickly; repair is normal. 5. I live in honest self-audit; correction is a strength.

Purpose/meaning beyond self

1. I feel aimless; life is mostly reactive or pleasure-driven. 2. I want purpose but don’t live from it consistently. 3. Some purpose; not consistently embodied. 4. Clear purpose influences my habits and choices. 5. Purpose is central; my life is organized around it.

Family

Immediate, Extended, or Chosen

Presence and reliability

1. I’m absent, avoidant, or inconsistent; others can’t rely on me. 2. I try but I’m often distracted or unavailable. 3. I show up sometimes; inconsistency is common. 4. I’m dependable most of the time; I follow through. 5. I’m a stable pillar; presence and reliability are my norm.

Repair after conflict

1. I avoid, blame, withdraw, or explode—repair rarely happens. 2. Repair is delayed; pride/avoidance slows it down. 3. I repair sometimes; not consistently. 4. I repair quickly most of the time. 5. I initiate repair as a standard; conflict leads to growth.

Communication quality

1. Communication is volatile, avoidant, or unclear. 2. I communicate inconsistently; tension builds. 3. Mixed—some healthy, some unhealthy patterns. 4. Mostly clear and respectful. 5. Clear, honest, steady communication—even in hard moments.

Responsibility and leadership in the family system

1. I contribute to instability or carry little responsibility. 2. I carry responsibility sometimes, but inconsistency hurts. 3. Some leadership; needs strengthening. 4. I contribute to stability consistently. 5. I lead by example; I create order, safety, and steadiness.

Values embodied at home

1. Home relationships contradict who I claim to be. 2. Some alignment, but stress exposes big gaps. 3. Mixed alignment; improving. 4. Mostly aligned; gaps are repaired quickly. 5. Strong coherence; my values show up most at home.

Relationships

Non-Family Connections

Relationship selection

1. I keep relationships that pull me down or compromise me. 2. I know better but don’t consistently choose well. 3. Mixed; I’m improving boundaries. 4. Mostly strong relationships that reinforce growth. 5. Relationships are curated; they strengthen virtue and direction.

Boundaries

1. No boundaries or harsh boundaries; chaos repeats. 2. Boundaries exist but collapse under pressure. 3. Mixed; sometimes held, sometimes not. 4. Mostly held with clarity and respect. 5. Clean boundaries; calm, firm, consistent.

Honesty + respect in conflict

1. I avoid or attack; truth is not handled well. 2. I try, but reactivity often wins. 3. Mixed—some skill, some old patterns. 4. Mostly honest and respectful. 5. Highly skilled truth-telling; conflict becomes constructive.

Emotional safety (regulated presence)

1. I’m unpredictable; closeness creates tension. 2. Sometimes safe, sometimes reactive. 3. Improving; inconsistency remains. 4. Mostly regulated and safe. 5. Consistently safe; people can trust my emotional steadiness.

Repair and accountability

1. I rarely repair; I justify, disappear, or blame. 2. Repair happens late, after damage. 3. Repair is inconsistent. 4. Repair is normal; accountability is strong. 5. I lead repair; accountability is identity-based.

Career

Work + Professional Growth

Execution consistency

1. I procrastinate/avoid; execution is unreliable. 2. I start strong then fade. 3. Mixed; inconsistent under stress. 4. Mostly consistent; I deliver. 5. Highly consistent; I execute regardless of mood.

Time and attention management

1. I’m scattered; priorities get swallowed by distraction. 2. I try systems but don’t sustain them. 3. Some structure; inconsistent. 4. Mostly structured; distractions are managed. 5. Strong attention discipline; priorities are protected daily.

Mastery orientation

1. I coast or avoid discomfort; growth is stalled. 2. I want mastery but choose comfort too often. 3. Mixed; growth comes in spurts. 4. Mostly mastery-driven; discomfort is accepted. 5. Deep craft/maturity; mastery is a lifestyle.

Pressure response

1. Pressure makes me reactive, avoidant, or chaotic. 2. I wobble under pressure; stability is inconsistent. 3. Mixed; learning. 4. Mostly stable under pressure. 5. Pressure sharpens me; I stay coherent.

Alignment with values/vision

1. Work contradicts my values or I’m drifting without direction. 2. Some alignment but not consistent. 3. Mixed; I’m clarifying. 4. Mostly aligned and intentional. 5. Strong alignment; work expresses mission and character.

Contribution

Service Beyond Self

Service beyond self

1. Little contribution; life is mostly self-focused. 2. Sporadic contribution; inconsistent. 3. Occasional contribution; not structured. 4. Consistent contribution. 5. Contribution is central; I serve predictably.

Using strengths to build others

1. I mostly use my strengths for myself. 2. I intend to help, but it’s inconsistent. 3. Mixed; I’m learning to invest. 4. I build others regularly. 5. I multiply others; mentorship/service is deliberate.

Follow-through on commitments

1. I drop commitments; reliability is weak. 2. I follow through sometimes; stress breaks it. 3. Mixed reliability. 4. Mostly dependable. 5. Highly dependable; my word carries weight.

Legacy orientation

1. I’m not thinking legacy; I’m surviving day-to-day. 2. I think about it but don’t act consistently. 3. Mixed; some actions. 4. Regular actions aligned with legacy. 5. Legacy is lived now; choices reflect long-term responsibility.

Responsibility for impact

1. I don’t consistently consider how I affect others. 2. I intend well, but impact is inconsistent. 3. Mixed awareness. 4. Mostly responsible and considerate. 5. Highly responsible; I steward influence carefully.

Finances

Stewardship + Structure

Awareness of financial reality

1. I avoid numbers; I don’t know where I stand. 2. I look occasionally, but avoid consistency. 3. Some awareness; inconsistent tracking. 4. Mostly aware; numbers are known. 5. Clear awareness; I review and adjust routinely.

System and structure

1. No system; spending is reactive. 2. I’ve tried systems but don’t maintain them. 3. Some structure; inconsistent. 4. Mostly structured; I follow it. 5. Strong system; stewardship is habitual.

Planning and foresight

1. No planning; emergencies create chaos. 2. Some planning; inconsistent. 3. Mixed planning. 4. Mostly planned; fewer surprises. 5. Strong planning; financial stress is minimized.

Restraint and delayed gratification

1. Impulsive spending/coping is common. 2. I restrain sometimes but break under stress. 3. Mixed restraint. 4. Mostly disciplined. 5. Highly disciplined; long-term > short-term.

Integrity and stewardship

1. Money habits contradict my values. 2. Some integrity but inconsistent. 3. Mixed; improving. 4. Mostly aligned with stewardship. 5. Strong stewardship; generosity/restraint/order are consistent.

THE I AM

Project

Rebuilding clarity, coherence, and identity from the center outward.

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