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Dance Therapy Emotional Assessment Form

The document is a registration form for an Emotions & Dance Therapy program, collecting personal information such as gender, age, and previous experience with dance therapy. It includes a series of statements for participants to rate their emotional awareness and interpersonal skills on a scale of 1 to 5. The form concludes with a thank you note for the participant's response.

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Vinita Seshadri Management Studies
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6 views2 pages

Dance Therapy Emotional Assessment Form

The document is a registration form for an Emotions & Dance Therapy program, collecting personal information such as gender, age, and previous experience with dance therapy. It includes a series of statements for participants to rate their emotional awareness and interpersonal skills on a scale of 1 to 5. The form concludes with a thank you note for the participant's response.

Uploaded by

Vinita Seshadri Management Studies
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Emotions & Dance Therapy

Registration No: _______________________


Gender: Male / Female Program: ____________________________________
Age: ______________________________
Have you attended any Dance Therapy Sessions earlier?: Yes/ No
 Please mark your response on a scale of 1 to 5 with a
1= Being Strongly Disagree; 2 =Disagree; 3 Neutral; 4= Agree ; 5= Strongly Agree
[Link] Statements 1 2 3 4 5
1 I know when to speak about my personal problems to
others
2 When I am faced with obstacles, I remember times I
faced similar obstacles and overcame them
3 I expect that I will do well on most things I try
4 Other people find it easy to confide in me
5 I find it hard to understand the non-verbal messages of
other people
6. Some of the major events of my life have led me to re-
evaluate what is important and not important
7 When my mood changes, I see new possibilities
8 Emotions are one of the things that make my life worth
living
9 I am aware of my emotions as I experience them
10 I expect good things to happen
11 I like to share my emotions with others
12 When I experience a positive emotion, I know how to
make it last
13 I arrange events others enjoy
14 I seek out activities that make me happy
15 I am aware of the non-verbal messages I send to others
16 I present myself in a way that makes a good
impression on others
17 When I am in a positive mood, solving problems is
easy for me
18 By looking at their facial expressions, I recognize the
emotions people are experiencing
19 I know why my emotions change
20 When I am in a positive mood, I am able to come up
with new ideas
21 I have control over my emotions
22 I easily recognize my emotions as I experience them
23 I motivate myself by imagining a good outcome to
tasks I take on
24 I compliment others when they have done something
well
Statement 1 2 3 4 5
25 I am aware of the non-verbal messages other people
send
26 When another person tells me about an important
event in his or her life, I almost feel as though I have
experienced this event myself
27 When I feel a change in emotions, I tend to come up
with new ideas
28 When I am faced with a challenge, I give up because I
believe I will fail
29 I know what other people are feeling just by looking at
them
30 I help other people feel better when they are down
31 I use good moods to help myself keep trying in the
face of obstacles
32 I can tell how people are feeling by listening to the
tone of their voice
33 It is difficult for me to understand why people feel the
way they do

THANK YOU FOR YOUR RESPONSE

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