Personal Needs Assessment 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