Step 3 of 3:

Revenant Personal Assessment

Lastly, please complete the assessment below.

First name

Last name

Marital history and present status:

Children (names and ages):

List names of the people with whom you live with and their relationship to you:

Briefly describe your religious views and practices, both past and current:

Briefly describe any military service (location, branch, rank, duty):

Briefly describe your present occupation, work, or job:

Briefly describe your educational background:

What is your present state of health?

Are you pregnant?

(Pregnant women may not participate in The Revenant Process)

Describe your physical appearance:

Briefly describe at least three events (preferably from your childhood) that have most influenced the beliefs you have about yourself, others, and the world in general:

How would a person who knows you well describe you?

Describe, in detail, a vision that has, or would have, you wake up every morning inspired and excited to contribute yourself fully to life:

What actions do you need to take to live your vision? Be specific:

If, at the end of your life, you had an opportunity to evaluate it, what would you have accomplished, and who would you have been for your family, friends, community, and so forth?: