Sierra Center for Peak Perfromance

STEP I:
PERSONALIZED ASSESSMENT
for
Academics Excellence

Use this form to set goals and action steps related to your academic career. Dr. Beale will turn your goals and action steps into powerful affirmations that will motivate, inspire and reinforce your efforts to reach your goals.

To take the first step in the development of a personalized training program that is specific to you, your academic support needs and your unique circumstances, simply complete this form and click on "Send" at the bottom.

If you are not sure how affirmations can help you see: http://www.drrelax.com/ezine1.htm#3

What is your first name?
What is your last name?
What is your gender?
What is your age?
When is your next exam?
What are your process goals for studying  and taking exams? Give at least 4 Goals.

(Process = things you must do to be at your best during the exam. Avoid Outcome goals. Outcome = passing the exam, achieving a specific score, etc)		 1.
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What must you do to achieve each of the goals stated above? (What actions must you take?)* Note that Step 1 is the action you must take to achieve Goal 1 and each step should be paired with each goal above. 1.
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5.
What is the single biggest challenge to reaching your goals?
What feelings or emotions do you have when studying or taking exams and everything is perfect? (Try to name more than four if you can.) 1.
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What specifically do you believe my tapes and training will help you to improve?
Name persons, that you admire. 1.
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Daytime Phone
Evening Phone
E-Mail address to receive your draft affirmations


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