Date:

Time (optional):

Please rate the overall "pleasantness" or "comfortableness" of your current state of being (10 is the highest, most pleasant state of being or most comfortable state of being possible):

Pleasantness Rating

1  2  3  4  5  6  7  8  9 10

How does your body feel?  (What observations can you make about sensations in your body?  Do you feel tension in a certain area?  Coldness/Warmth?  Pain?  Pleasure?  Do you feel energetic?  Vibrant?  Sore?  Point form is fine!)

What is in your mental environment?  (What do you find yourself thinking about, in the last ten minutes or so?  Is your mind active, or quiet?  Do you have productive thinking, or non-productive thinking?  Are you focused on the past, present or future?  Do you seem focused on concerns of the ego/personality, or "concerns" of the higher self/observer, such as unconditional love, acceptance, and joy?)

How do you feel emotionally?  (What emotional words describe how you feel right now?)

Comments/Other Observations:

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