What is the Self-Assessment Form?

The Sound Wellness Self-Assessment is a tool designed to help you reflect on your overall well-being across four key dimensions: physical, emotional, mental, and spiritual. It captures your current perspective on wellness and provides insight into how you feel overall.

A blank "Additional Comments or Symptoms" section is included at the end of the form for any concerns, challenges, or aspects of wellness that don’t fit neatly into these four dimensions. If you're unsure where something belongs, feel free to note it here or in your journal for later discussion and clarification.

This assessment represents a snapshot of your wellness at this moment (NOW). Taking it periodically can help you track changes over time as you make lifestyle adjustments, engage in sound healing sessions, or adopt new self-care practices.

As part of a holistic approach, I will also assess your wellness before and after sessions, offering personalized self-care recommendations to support your healing journey and enhance overall well-being.

This form is available both online and in print—please let me know if you’d prefer a paper copy.

Completing the Self-Assessment Form

When should I do it?

• Complete the self-assessment after reviewing the instructions and/or with guidance from me.

• If your wellness concerns, challenges, or dimension items are relatively stable, complete the assessment weekly, ideally at the same time each day.

• If changes occur more frequently, complete the form more often (e.g., daily or every 2–3 days) while implementing self-care “homework” recommendations.

• For physical pain or discomfort, use the Body Map to indicate the location by marking an “X” or circling the affected area. Write the date next to the mark for tracking purposes.

• Your self-assessment will be reviewed and discussed at each scheduled sound session, so please have a completed copy (digital or print) accessible during your session.

How should I complete the form?

• For Physical, Emotional, and Mental Wellness, rate the intensity of each challenge or issue on a 0 to 10 scale, where:

  • 0 = No challenge/issue or the best possible experience

  • 10 = The most intense challenge/issue or worst possible experience

  • Base your rating on how you feel in the present moment. I may also ask additional questions, such as how the intensity has fluctuated over the past 24 hours (best and worst points).

• For Spiritual Wellness and Overall Well-being, rate your experience on a 0 to 10 scale, where:

  • 10 = The best possible sense of well-being

  • 0 = The worst possible sense of well-being

  • Again, rate according to how you feel right now, with the possibility of further discussion about variations over the past 24 hours.

• Only rate and record the dimensions that are a priority for you at this time. However, if your situation changes, you can begin tracking new dimensions as needed.