Mental Game Assessment

Full Name *

First Name

Last Name *

Last Name

Sport *

Email *

Phone Number *

Directions: Please respond to the statements below by selecting a number in the scale (1 = always, 7 = never). After you have completed the form, select "submit" to send to Coach John for a free analysis.

I have challenges setting goals and working a plan to meet those goals *

1

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7

AlwaysNever

My success in practice is better than during competition *

1

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7

AlwaysNever

I am self-conscious and worry about what others think about my performance. *

1

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7

AlwaysNever

Self-doubt before or during games limits my success. *

1

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7

AlwaysNever

Letting others down by not performing up to expectations is something I worry about. *

1

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7

AlwaysNever

I am self-conscious and worry about how others may perceive me. *

1

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7

AlwaysNever

Before or during competitions I worry, am often tense, or may be anxious. *

1

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7

AlwaysNever

Pre-game jitters do not go away after the first few minutes into the competition. *

1

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7

AlwaysNever

I am motivated by fear or failure and it affects me in competitions. *

1

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7

AlwaysNever

My fear of success can often sabotage my performance when I am winning. *

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7

AlwaysNever

At times I am confused why I play my sport or why others motivate me. *

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7

AlwaysNever

External results, accolades, recognition, or praise are key motivators for me. *

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7

AlwaysNever

My self-worth is often connected to how well I perform in sports. *

1

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7

AlwaysNever

I often lose focus or have mental lapses during critical times of the game. *

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7

AlwaysNever

My routines are not well defined or lack mental focus in routine. *

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7

AlwaysNever

I find myself going through motions physically without mental focus or intensity. *

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7

AlwaysNever

I am not excited enough or I am too excited to perform my best in competition. *

1

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7

AlwaysNever

I am distracted or easily taken off task by things that go on around me. *

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7

AlwaysNever

I experience fear, uncertainity, doubt or negative thoughts before, during or after competition. *

1

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7

AlwaysNever

Thoughts about my previous injuries limit me from performing as well as before. *

1

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7

AlwaysNever

When doing well, a comfort zone (protecting my lead) limits my ability to perform. *

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7

AlwaysNever

I become easily frustrated because of high expectations others or I place on me. *

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7

AlwaysNever

Playing with freedome or trust and without hesitancy when under pressure is difficult. *

1

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7

AlwaysNever

I work on mecahnics or technique even when competing or during a game. *

1

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7

AlwaysNever

I have difficulty concentrating in the present, and here and now. *

1

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7

AlwaysNever

I think too much about the consequences of my performance, good or bad. *

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7

AlwaysNever

I over analyze mistakes (technique) and thus think too much about technique. *

1

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6

7

AlwaysNever

I have low-self-confidence or self-esteem about my athletic abilities success. *

1

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7

AlwaysNever

I often give myself labels like, "I am a choker" or "I hope I don't mess this up". *

1

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7

AlwaysNever

Letting go of poor past performances is difficult for me. *

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7

AlwaysNever

Anger and/or frustration gets in the way of performing my best. *

1

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7

AlwaysNever

I am often disappointed with my performance and wish it was better. *

1

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6

7

AlwaysNever

I just want to be the best ever at my sport and want to know how to improve my mental game. *

1

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6

7

AlwaysNever

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