Self Concept Inventory

Complete the inventory about yourself and have at least two other people (preferably a male and
female) complete similar inventories about you (see pages 2-3 next page). Please all three
responses.

Describe yourself in the following four areas of self. (Don’t be vague. Use specific words,
phrases, or sentences).

Physical (appearance, condition of body, health):

Mental (abilities, preferred ways of learning, attitude, or mental outlook):

Emotional (usual feelings or typical ones in certain situations):

Social (behaviors around others, preferences for types of social activities):

What would you like to change about yourself in each of these areas?

Complete the following sentences.

Some relationships that are important to me are

Two of my skills or talents are
Two characteristics or behaviors I appreciate in myself are
One thing I would like to improve about myself is
I am proud of myself for
A goal I have for myself is
My top four values are
On average I spend my time (be specific)
On a scale from 1-10 I would rate my self esteem as?
What would you do if you had one million tax free dollars?
If you only had 1-3 months to live what would you do with that time?
What do you spend most of your time thinking about?

(adapted from Hanna, S. (2003). Person to Person: Positive Relationships Don’t Just Happen.
Prentice Hall: New Jersey.
 Self Concept Inventory

Please complete the following questions about: ___________________________________

My relationship to this person is: ________________________________

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How would the person describe him/her self in the following four areas: (Don’t be vague. Use
specific words, phrases, or sentences. He/she is looking for specific feedback about what you
believe he/she thinks of him/her self.).

Physical (appearance, condition of body, health):

Mental (abilities, preferred ways of learning, attitude, or mental outlook):

Emotional (usual feelings or typical ones in certain situations):

Social (behaviors around others, preferences for types of social activities):

What would this person like to change about him/her self?

Please answer the following questions regarding the person asking you to complete this
form:

Some relationships that are important to this person are…

Two of this persons skills or talents are…

Two characteristics or behaviors this person appreciates about him/her self are…

One thing about self this person would like to improve is …

One thing this person is proud of is…

One of this person’s goals is…

What are the most important values of this person (four)?

On average this person spends most of his/her time (be specific)…

On a scale from 1-10 how would he/she rate his/her self- esteem?

What would this person do if he/she had one million tax free dollars?

If this person only had 1-3 months to live what would he/she do with that time?

What does this person spend most of his/her time thinking about?

(adapted from Hanna, S. (2003). Person to Person: Positive Relationships Don’t Just Happen.
Prentice Hall: New Jersey.