Needs Assessment Worksheet

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Personal Worksheet

 

 

Rate the influence of the following needs on your life, your behaviors, and your decisions – “1” being the most influential and “5” being the least influential.   Add other needs you consider influential to the bottom of the list.

 

 

NEEDS Very influential     ?    Less influential
Wealth 1 2 3 4 5
Status/prestige 1 2 3 4 5
Power 1 2 3 4 5
Control 1 2 3 4 5
Adventure 1 2 3 4 5
Stability 1 2 3 4 5
Order 1 2 3 4 5
Security 1 2 3 4 5
Someone to rely on 1 2 3 4 5
Belonging 1 2 3 4 5
Love 1 2 3 4 5
Friendships 1 2 3 4 5
Family 1 2 3 4 5
Happiness 1 2 3 4 5
Expressing individuality 1 2 3 4 5
Creativity 1 2 3 4 5
Independence 1 2 3 4 5
Spiritual fulfillment 1 2 3 4 5
Personal achievement 1 2 3 4 5
Perfectionism 1 2 3 4 5
Be correct and not make mistake in front of others 1 2 3 4 5
Be admired by others 1 2 3 4 5
Attention of others 1 2 3 4 5
Not look foolish 1 2 3 4 5
Make others happy 1 2 3 4 5
Have fun 1 2 3 4 5
Make people laugh 1 2 3 4 5
Be accepted by others 1 2 3 4 5
Care for others 1 2 3 4 5

 

Other very influential needs affecting your life, your behaviors, and your decisions:

 

List your eight most influential needs:

1.

2.

3.

4.

5.

6.

7.

8.

 

Which needs might you want to alter or change (e.g. the need to rely on others, the need to be perfect, etc…)?

 

Printable version of Needs Assessment – Needs Assessment

 

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