Instructions for completing this exercise
The information you provide will be treated with the utmost respect and confidentiality. You'll receive a copy sent to your e-mail when you submit the form.
The purpose of this evaluation is to become more aware of strengths and limitations and to explore possibilities.
There may be some unfamiliar terminology in this form we have provided notes sections should you wish to elaborate or ask questions.
If you prefer to do this exercise in person, please contact to set up an appointment. 206 291 7979.
Estimated time to complete this form is 10 minutes.
Once submitted a copy will be e-mailed to you.