Azaya Pre-Event Questionnaire and Life Evaluation
Thank you for your submission. Please click here to download a copy of your report.

Please complete this form fully using the most open and personally honest communication available to you. The more candid your replies, the better foundation you lay for our coaching relationship.

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Evaluation: Emotional Balance - 7 Core Emotional Needs

Everyone is trying, all the time, to satisfy seven emotional requirements . The degree to which, and the way in which, these requirments are met will determine moer about a person's happiness than anything else. For this section, please indicate to what degree these needs are being met in your life and whether you think you are satisfying them in productive or unproductive ways.

Need Description 0-100
Meaning How much meaning do you find in your life as things are today?
Significance How important do you feel in your life at the moment?
Certainty How certain do you feel about your life and your future?
Uncertainty How much variety and entertainment do you have in your life right now?
Connection How much connection/love do you experience consistantly now?
Growth Compared to your potential, how much growth are you experiencing in your life?
Contribution Compared to your potential, how much do you contribute to the world around you?
Emotional Needs Analysis
Life Balance: How balanced is your life right now? How are you doing in each area of life?

Looks at your emotional needs at a macro level (your whole like, as in part I, is always interestig. I find it even more powerful to look at the human needs as they relate to different areas of life.

Area of Life Right Now Next 12 Months Current Imporance to You What SHOULD be most important?
2 Your Environment Out of 10 (1 being lowest, 10 being highest), please rate each area of life for the time period shown above. For example, in the first box, please rate your Finances out of 10 for last year. Then, in the next box to the right, rate your Finances right now and then how you feel about your financial future. Then do the same for each subsequent area of life and then place them in order (rank).
2 Spiritual Life
2 Fun / Enjoyment
1 Community
3 Family and Friends
3 Money / Finance
2 Professional Life
1 Personal Growth
3 Health / Fitness
1 Romantic Life
Present View
Areas that Require Focus
Toleration: What are you putting up with in your life?

Being tolerant often appears to be functional and strong but, in truth, toleration is much more like writing emotional cheques that must be cashed later.

If you tolerate things that annoy you then your annoyance will surface eventually. Tolerating requires your energy and is, therefore, energy draining. What we will work on throughout your coaching is to move things from toleration to acceptance and then, if we are really successful, to gratitude.

Please complete the section below with some of the things you are currently tolerating.

AZAYA: What are your intentions for this program and your life following this program?

AZAYA is a highly intimate program and a deeply personal process. The following statements will tell Eric a great deal about what specifically you are hoping to gain from this experience and how he can support you in the best possible way.

My Goals for the next 12 months

Please indicate below this year's top three goals in each area of life

What is holding you back right now?

What is or has been holding you back or challening your progess in each of these areas of life.

How would each of these areas of your life be if 'things' were different?
What are some of the 'things' (about you, the people around you, the world) that need to be different?
Are there any habits or rituals that you would like to change or stop?
Please take a moment to write to Eric about any issues that you think he should be aware of relative to your participation in Azaya. This might include things like; things you are hoping to get from the program; challenges you are facing that you need help with, unresolved issues or events from your past, irrational fears or emotional states that you would like to escape. Be open - the more open you are, the easier it will be for Eric to help you.
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