Mindfullness Self Assesment Questionnaire

Evaluation of Mindfulness sessions. Read your weekly evaluations then complete the following questions honestly and in as much detail as possible.

Questions for Mindfullness Self Assesment Questionnaire

1.

What are the most important things in your life right now?

The answer should be a text input.
2.

What is the purpose of "___" things for you?

The answer should be a text input.
3.

How would you describe your relationship with yourself?

The answer should be a multiple choice:
  1. I practice being grateful for your body
  2. I'm kind to myself
  3. I let go of being perfectionist
  4. I let go of judgement
4.

How would you describe your relationship with others?

The answer should be a single choice:
  1. I like to surround myself with people who have similar interests and ideas to my own; my friends and I just get each other.
  2. I love my best friends, but I’m always trying to expand my circle to include new people.
  3. I tend to have just a few best friends, and I would trust them with anything.
  4. I think of my close friends as family, and I know that we all have each other’s backs.
5.

How often do you feel overwhelmed by physical pain?

The answer should be a text input.
6.

How often do you avoid doing things that make you uncomfortable because of the fear of pain?

The answer should be a single choice:
    7.

    How frequently are your thoughts on a particular day?

    The answer should be a single choice:
    1. Too much
    2. Too little
    3. Just right
    8.

    How often do you feel happy?

    The answer should be a single choice:
    1. Too much
    2. Too little
    3. Just right
    9.

    How often do you feel angry with others?

    The answer should be a single choice:
    1. Too much
    2. Too little
    3. Just right
    10.

    What types of thoughts do you tend to engage in when doing something that requires thinking before acting (e.g., driving)?

    The answer should be a text input.

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