Please answer the following questions on a scale of 1 to 5, with 1 being the least and 5 being the most.

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* 1. Please enter the following information:

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* 2. How did you learn of this assessment?

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* 3. How well do you understand the history of retirement?

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* 4. How much do you know about normal psychological features of people who are over 65?

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* 5. How well do you understand the stages of human psycho-social development?

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* 6. Do you know the three core elements of every transition between stages of life?

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* 7. How well do you understand your strongest and weakest personality skills?

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* 8. Can you name your core values, your guiding principles in life?

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* 9. Can you name your top sources of meaning in life, that inspire you to attack each new day?

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* 10. How pleasant do you think it will be to fill your time with activities other than work?

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* 11. Have you chosen some long range projects that feel truly significant?

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* 12. Have you made a plan for strengthening the relationships that will give your days meaning?

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* 13. Have you found some non-work activities that will give your days meaning?

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* 14. Is your identity based less than 50% on your work role?

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* 15. Have you made a plan for polishing out the rough spots in your personality?

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* 16. Have you created a robust, multifaceted activity schedule for your yourself after fulltime work?

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* 17. Have you made a plan for spending time with people who matter most to you?

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* 18. How completely have you told your spouse or partner your dreams, plans, and fears about life after fulltime work?

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* 19. How completely have you heard your spouse or partner describe their dreams, plans, and fears about life after fulltime work?

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* 20. How ready are you to answer the question, "What do you do?" without mentioning your job or career?

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* 21. Have you read at least three popular books about retirement?

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* 22. How optimistic are you that your life after fulltime work will be enjoyable and meaningful?

Thank you for taking this assessment.  Dr. Paul will contact you to schedule a complementary appointment for visiting his office and reviewing your results together.

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