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Step 1

The Healing H.E.M. Ministry Clinc

The Assessment

Aids in determining your specific needs.

Once your assessment is received, the Initial Consultation will be scheduled (online).

The Assessment Form

Status
Please select any health condition below that is applicable to you:
Do you experience any of the following feelings:

Social

Do I take time to meaningfully interact with family/friends?
Yes
No

Mental Wellness

I express my feelings of anger/frustration constructively.
Yes
No
I set objectives/goals for myself and work towards accomplishing them.
Yes
No
I feel have someone to confide in to share and pray with me.
Yes
No
I take responsibility for my actions.
Yes
No

Emotional Wellness

I have spiritually healthy relationships.
Yes
No
I am confident in myself.
Yes
No
I respect others, regardless of their race, age, gender, or attitude.
Yes
No

Mind Wellness

I keep up to date in what is going on in my City, Country, the world.
Yes
No
I seek opportunities to learn new things through T.V., books, or the internet.
Yes
No
Before I make a decision, I get all of the facts and assess all options.
Yes
No

Values, Spirituality, & Beliefs

I feel my life has purpose.
Yes
No
My actions are guided by my own beliefs, not by other's beliefs.
Yes
No
I have daily devotion/prayer time with God.
Yes
No
I am operating in my purpose God has given me.
Yes
No

Generational Area

Trauma

Have I had a traumatic experience(s) as a child/teen/adult that i am still dealing with?
Yes
No
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