The Conscious Bridge™ Family Insight Assessment

This assessment explores your child’s natural way of thinking, learning, and understanding emotions.

We encourage your child to fill out this assessment themselves. If they are unable to do so, a parent may complete it based on the child’s everyday behaviour and habits.

Your child’s responses will be combined with the parent’s live assessment to create a personalised Bridge Guide during The Conscious Bridge™ coaching sessions.

Please note: You will receive the combined report within 24 hours after both the live parent session and this assessment are completed. The report is not provided during the first session.

Please answer based on real behaviours, there are no right or wrong answers.

Use the following scale:

1 = Strongly Disagree
2 = Disagree
3 = Neutral
4 = Agree
5 = Strongly Agree

Your Full Name (Person completing this form) *

Example: “Anna Wijaya”

Email Address *

The report will be emailed to the parent joining the sessions. You may enter that parent's email here.

Your Role in the Family *

Full Name of the Child *

Placeholder: Example: "Rafi Wijaya"

Child’s Age *

"Example: 10"

Who is completing this form? *

What is your main goal or question for this report? *

Example: “I want to understand my child’s learning motivation and communication style.”

Describe any recurring family challenges or situations you’d like clarity on.

Example: “We often argue about routines and responsibility.”

Consent *

I agree to the Privacy Policy and Terms, and I consent to my responses being processed to generate my Mind Modes® assessment and report. If I provide information about another person (e.g., partner/child), I confirm I have their permission to do so. Your information is kept confidential and used only for preparing your report.

Yes

Understand your family on a deeper level

This assessment helps us understand how each family member thinks, learns, and responds. Your responses will be combined and reviewed during The Conscious Bridge™ parent coaching sessions. There are no right or wrong answers. Answer naturally.

The Conscious Bridge™ Family Insight Assessment