Welcome to your Self-Confidence Assessment Instructions: Please fill out the information below (all fields are required), click next for the list of statements dealing with your general feelings about yourself. Please indicate how strongly you agree or disagree with each statement. Name Email Phone 1. On the whole, I am satisfied with myself. Strongly Agree Agree Disagree Strongly Disagree None 2. At times I think I am no good at all. Strongly Agree Agree Disagree Strongly Disagree None 3. I feel that I have a number of good qualities. Strongly Agree Agree Disagree Strongly Disagree None 4. I am able to do things as well as most other people. Strongly Agree Agree Disagree Strongly Disagree None 5. I feel I do not have much to be proud of. Strongly Agree Agree Disagree Strongly Disagree None 6. I certainly feel useless at times. Strongly Agree Agree Disagree Strongly Disagree None 7. I feel that I'm a person of worth, at least on an equal plane with others. Strongly Agree Agree Disagree Strongly Disagree None 8. I wish I could have more respect for myself. Strongly Agree Agree Disagree Strongly Disagree None 9. All in all, I am inclined to feel that I am a failure. Strongly Agree Agree Disagree Strongly Disagree None 10. I take a positive attitude toward myself. Strongly Agree Agree Disagree Strongly Disagree None 1 out of 2 Time's up
