Follow-Up Assessment

Personal Peace Assessment

Rate your level of peace and satisfaction in five life areas (0–100%). Your average score reflects your overall Personal Peace Index.

Client Full Name *

Date of Assessment *

Session Number / Notes (optional)

For each category, drag the slider to reflect your current level of peace or satisfaction (0 = none, 100 = complete). Your five scores will be averaged to give your Personal Peace Index.

🕊️

SpiritualFaith, purpose, inner connection, values alignment

50%

💪

PhysicalHealth, energy, body care, sleep, nutrition

50%

🧠

Mental / EmotionalMindset, emotional regulation, mental wellness, clarity

50%

🤝

Social / RelationalRelationships, community, support systems, belonging

50%

💰

FinancialFinancial stability, security, stewardship, provision

50%

Personal Peace Index

50%

Average of your five category scores

Reflection — What area needs the most attention right now? (optional)

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