Questionnaire 1

Choose one of four options in response to each statement that follows. Choose the degree to which the statement applies to you. Be honest with yourself and choose the option that most accurately describes you NOW and NOT how you would like to be.

Left: NOT LIKE ME AT ALL

Left Middle: NOT MUCH LIKE ME

Right Middle: SOMEWHAT LIKE ME

Right: A LOT LIKE ME

NOT LIKE ME AT ALL
A LOT LIKE ME

I love eating cupcakes {sample only}