Goal Clarification & Readiness Assessment

This assessment encourages reflection on one's goals, the reasons behind them, and the barriers to achieving them, while also fostering a sense of actionable progress.

When completing this form, provide as much or as little information as you'd like. However, the more details allows for greater insight.

And remember, there are no wrong answers and your entries are completely confidential.

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Name

First

Last

My goal or dream is to:

I have had this goal/dream for:

Provide an approximate length of time. Example: Three years and four months.

The reason this goal/dream is so important to me is because:

I first realized I wanted to pursue this goal/dream when:

The reason I haven't pursued this goal/dream yet is because:

The biggest limitation I feel is holding me back from achieving this goal/dream is:

If I were to overcome this limitation, the first step I would take toward my goal/dream would be:

The thought of achieving this goal/dream makes me feel:

I believe that achieving this goal/dream would change my life in the following ways:

When it comes to support systems:

I HAVE a person who could support me in pursuing this goal/dream.
I DO NOT HAVE a person who could support me in pursuing this goal/dream.
I'm not sure if I have someone who could support me in pursuing this goal/dream.

When I think about never achieving this goal, I feel:

Progress I've made toward achieving this goal include: (Select all that apply.)

Clearly Defined the Goal
Written my Goal Down
Shared my Goal with a Supporter (family member, friend, mentor, etc)
Created a Plan with Small Actionable Steps
Set a Timeline
Identified Resources & Support

toward goal When

I'm ready to start working toward my goal immediately!

Please indicate your level or readiness.