Six Week Reset- Week 1 – Beeing Well with Brooke

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Week 1: Baseline Nervous System Mapping

This assessment creates a snapshot of your nervous system today. There are no right or wrong answers. Answer are based on your experience over the past few weeks. We will revisit many of
these questions throughout our program together to recognize your growth and increased capacity.

Stress Level (for the past month)

Selected Value: 0

Overall, how stressed do you currently feel? 1–10 (1 = Completely at ease | 10 = Constantly overwhelmed)

Current Capacity

Selected Value: 0

How much capacity do you currently have for your daily life? 1–10 (1 = I feel maxed out | 10 = I feel spacious, resilient, and capable)

Stress energy

Safety & Connection

Selected Value: 0

How safe and connected do you feel in your body? 1–10 (1 = Rarely settled or grounded | 10 = Deeply at home in my body)

Your energy levels

Selected Value: 0

How would you rate your overall energy? 1–10 (1 = Completely depleted | 10 = Energized and vital)

Quality of sleep

Selected Value: 0

How would you rate your sleep quality? 1–10

Which best describes your current sleep?

I sleep well and wake feeling restored
I occasionally have disrupted sleep
I wake during the night
I have difficulty falling asleep
I wake feeling tired or unrested

How quickly do you recover after stressful experiences?

Where are you currently experiencing stress or tension? (Select all that apply.)

Where do you notice stress showing up in your body first?

What symptoms or patterns are you most aware of right now?

What are the three biggest stressors or challenges you are currently navigating?

Choose 3–5 words that best describe how you currently feel.

What would you most love to experience differently by the end of these six weeks?

If your nervous system felt fully supported, how would your life feel different?