Complimentary Clean Sweep Assessment

Not sure where you are now or where you want to be? Not sure if you need a coach and want to go to the next level? Your keys to your full potential dwell within you. You can unlock them and this free assessment will help you look at four areas of your life (environment, well-being, money, and relationships).

Go ahead. Take The Clean Sweep to help yourself identify your goals and make room for the life you want to create on your own terms. When done, submit your answers to me and I'll contact you for a complimentary consultation to discuss the areas of your life where you want to fill in the missing pieces or modify areas where you want to actively follow through and make meaningful, lasting changes in your life that allow you to flourish and strengthen your authenticity and truth.



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A. Physical Environment

1. My personal files, papers, and receipts are neatly filed away.
Yes      No     

2. My car is in excellent condition (doesn't need mechanical work, repairs, cleaning or replacing).
Yes      No     

3. My home is neat and clean (vacuumed, closets clean, desks and tables clear, furniture in good repair, windows clean.
Yes      No     

4. My appliances, machinery, and equipment work well (refrigerator, toaster, snowblower, water heater, toys).
Yes      No     

5. My clothes are all clean and pressed, make me look great (no wrinkles, baskets of laundry, or torn, out-of-date, or ill-fitting clothes).
Yes      No     

6. My plants and animals are healthy (fed, watered, getting light and love).
Yes      No     

7. My bed and bedroom let me have the best sleep possible (firm bed, light, air).
Yes      No     

8. I live in a home or apartment that I love.
Yes      No     

9. I surround myself with beautiful things.
Yes      No     

10. I live in the geographic area I choose.
Yes      No     

11. There is ample and healthy light around me.
Yes      No     

12. I consistently have adequate time, space, and freedom in my life.
Yes      No     

13. I am not damaged by my environment.
Yes      No     

14. I am not tolerating anything about my home or work environment.
Yes      No     

15. My work environment is productive and inspiring (synergistic, with ample tools and resources, and with no undue pressure).
Yes      No     

16. I recycle.
Yes      No     

17. I use non-ozone-depleting products.
Yes      No     

18. My hair is the way I want it.
Yes      No     

19. I surround myself with music that makes my life more enjoyable.
Yes      No     

20. My bed is made daily.
Yes      No     

21. I don't injure myself or bump into things.
Yes      No     

22. People feel comfortable in my home.
Yes      No     

23. I drink purified water.
Yes      No     

24. I have nothing around the house or in storage that I do not need.
Yes      No     

25. I am consistently early or easily on time.
Yes      No     



B. Health and Emotional Balance

26. I use caffeine (chocolate, coffee, colas, tea) less than three times per week, total.
Yes      No     

27. I rarely eat sugar (less than three times per week).
Yes      No     

28. I rarely watch television (less than five hours per week).
Yes      No     

29. I rarely drink alcohol (less than two drinks per week).
Yes      No     

30. My teeth and gums are healthy (have seen a dentist in the last six months).
Yes      No     

31. My cholesterol count is healthful.
Yes      No     

32. My blood pressure is healthful.
Yes      No     

33. I have had a complete physical exam in the past three years.
Yes      No     

34. I do not smoke tobacco or other substances.
Yes      No     

35. I do not use illegal drugs or misuse prescribed medications.
Yes      No     

36. I have had a complete eye exam within the past two years (glaucoma check, vision test).
Yes      No     

37. My weight is within my ideal range.
Yes      No     

38. My nails are healthy and attractive.
Yes      No     

39. I don't rush or use adrenaline to get the job done.
Yes      No     

40. I have a rewarding life beyond my work or profession.
Yes      No     

41. I have something to look forward to virtually every day.
Yes      No     

42. I have no habits that I find to be unacceptable.
Yes      No     

43. I am aware of the physical or emotional problems or conditions I have, and I am now fully taking care of all of them.
Yes      No     

44. I consistently take evenings, weekends, and holidays off and take at least two weeks of vacation each year.
Yes      No     

45. I have been tested for the AIDS antibody.
Yes      No     

46. I use well-made sunglasses.
Yes      No     

47. I do not suffer.
Yes      No     

48. I floss daily.
Yes      No     

49. I walk or exercise at least three times per week.
Yes      No     

50. I hear well.
Yes      No     


C. Money

51. I currently save at least 10 percent of my income.
Yes      No     

52. I pay my bills on time, virtually always.
Yes      No     

53. My income source or revenue base is stable and predictable.
Yes      No     

54. I know how much I must have to be minimally financially independent, and I have a plan to get there.
Yes      No     

55. I have returned or made good on any money I have borrowed.
Yes      No     

56. I have written agreements and am current with payments to individuals or companies to whom I owe money.
Yes      No     

57. I have six months' living expenses in a money market.
Yes      No     

58. I live on a weekly budget that allows me to save and not suffer.
Yes      No     

59. All my tax returns have been filed, and all my taxes have been paid.
Yes      No     

60. I currently live well, within my means.
Yes      No     

61. I have excellent medical insurance.
Yes      No     

62. My assets (car, home, possessions, treasures) are well insured.
Yes      No     

63. I have a financial plan for the next year.
Yes      No     

64. I have no legal clouds hanging over me.
Yes      No     

65. My will is up to date and accurate.
Yes      No     

66. Any parking tickets, alimony, or child support I owe is paid and current.
Yes      No     

67. My investments do not keep me awake at night.
Yes      No     

68. I know how much I am worth.
Yes      No     

69. I am on a career, professional or business track that is or will soon be financially and personally rewarding.
Yes      No     

70. My earnings are commensurate with the effort I put into my job.
Yes      No     

71. I have no loose ends at work.
Yes      No     

72. I am in relationships with people who can assist in my career or professional development.
Yes      No     

73. I rarely miss work due to illness.
Yes      No     

74. I am putting aside enough money each month to reach financial independence.
Yes      No     

75. My earnings outpace inflation, consistently.
Yes      No     



D. Relationships

76. I have told my parents in the last three months that I love them.
Yes      No     

77. I get along well with my sibling(s).
Yes      No     

78. I get along well with my coworkers and/or clients.
Yes      No     

79. I get along well with my manager and/or staff.
Yes      No     

80. There is no one who I would dread or feel uncomfortable running across (in the street, at an airport, or at a party).
Yes      No     

81. I put people first and results second.
Yes      No     

82. I have let go of the relationships that drag me down or damage me ("let go" means to end, walk away from, state a problem with, handle, or no longer be attached to.)
Yes      No     

83. I have communicated or attempted to communicate with everyone who I have damaged, injured, or seriously disturbed, even if it wasn't fully my fault.
Yes      No     

84. I do not gossip or talk about others.
Yes      No     

85. I have a circle of friends and/or family who love and appreciate me for who I am, more than just what I do for them.
Yes      No     

86. I tell people how they can satisfy me.
Yes      No     

87. I am fully caught up with letters and calls.
Yes      No     

88. I always tell the truth, no matter what.
Yes      No     

89. I receive enough love from people around me to feel good.
Yes      No     

90. I have fully forgiven those people who have hurt or damaged me, whether it was deliberate or not.
Yes      No     

91. I am a person of my word; people can count on me.
Yes      No     

92. I quickly clear miscommunications and misunderstandings when they do occur.
Yes      No     

93. I live life on my terms, not by the rules or preferences of others.
Yes      No     

94. There is nothing unresolved with my past loves or spouses.
Yes      No     

95. I am in tune with my wants and needs and get them taken care of.
Yes      No     

96. I do not judge or criticize others.
Yes      No     

97. I do not take personally the things that people say to me.
Yes      No     

98. I have a best best friend or soul mate.
Yes      No     

99. I state requirements rather than complaining.
Yes      No     

100. I spend time with people who don't try to change me.
Yes      No     



 

Intellectual Property Notice

This material and these concepts are the intellectual property of Coach U, Inc. You may not repackage or resell this program without express written authorization and royalty payment. The exception is that you may deliver this program to single individuals without authorization or fee. If you lead a workshop or develop or deliver a program to a group or company based on or including this material or these concepts, authorization and fees are required. You may make as many copies of this program as you wish, as long as you make no changes or deletions of any kind.



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