BUILD THE MAN · 100 DAY IMPLEMENTATION

Your Starting Point Assessment

Before the work begins, we document where you are. This is your baseline. Be honest. No one is grading you on the score.

Complete the below assessment for your baseline. Your answers stay with you and your coach. You will return to this same form on Day 50 and Day 100 to measure how far you've come.

Full Name *

Before you build, you document. This is your baseline. Score yourself honestly below, then answer the questions. You will return to this on Day 50 and Day 100.

Rate yourself today - 1 (lowest) - 10 (Highest)

On a scale of 1-10, how would you rate your current mental well-being? (1 = Very Low, 10 = Very High)

How grounded are you in your faith, values, and sense of purpose?

How would you rate your physical health, energy, and the way you feel in your body? *

How present and connected are you with your family? *

Where would you rate yourself financially/income/business? *

How would you rate your environment, the places you spend your time etc. *

How would you rate your leadership? *

Where am I right now? *

What is my biggest area of pain or struggle right now? *

What have I already tried that hasn't worked? *

What does my life look like if nothing changes in the next 12 months? *

What am I most committed to changing in the next 100 days? *

Photos - Day 1 Baseline

Attach your current state Day 1 photos below in shorts if your comfortable from the Front, Side, and Back. These are your starting point. You will compare these to your Day 50 and Day 100 photos.

Front *

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Side *

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Back *

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

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