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07 5574 3888
pto.enquiries@vitalityunleashed.com.au
Mon-Fri: 7am-7pm
Level 1, 105 Upton Street, Bundall GOLD COAST QLD 4217

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About Us
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Executive Skills Questionnaire – Revised (ESQ-R)

Instructions: Read each item and decide how often it’s a problem for you.

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1

2

3

Participant Information

First Name *

Last Name *

Email Address *

Phone *

Location *

Date of Birth *

Start the test:

1. I act on impulse. *

Never or rarely
Sometimes
Often
Very Often

2. I say things without thinking. *

Never or rarely
Sometimes
Often
Very Often

3. I lose things. *

Never or rarely
Sometimes
Often
Very Often

4. I have a short fuse. *

Never or rarely
Sometimes
Often
Very Often

5. I get upset when things don't go as planned. *

Never or rarely
Sometimes
Often
Very Often

6. I run out of steam before finishing a task. *

Never or rarely
Sometimes
Often
Very Often

7. It's hard for me to set priorities when I have a lot of things to do. *

Never or rarely
Sometimes
Often
Very Often

8. My desk or workspace is a mess. *

Never or rarely
Sometimes
Often
Very Often

9. I have trouble keeping my house or room clean *

Never or rarely
Sometimes
Often
Very Often

10. I have trouble estimating how long it will take to complete a task. *

Never or rarely
Sometimes
Often
Very Often

11. I'm slow at getting ready for school, work, or appointments. *

Never or rarely
Sometimes
Often
Very Often

12. If the first solution to a problem doesn't work, I have trouble thinking of a different one. *

Never or rarely
Sometimes
Often
Very Often

13. I skip checking my work for mistakes, even when the stakes are high. *

Never or rarely
Sometimes
Often
Very Often

14. I get annoyed when tasks are too hard. *

Never or rarely
Sometimes
Often
Very Often

15. It's hard for me to put aside fun activities to start things I know I need to do. *

Never or rarely
Sometimes
Often
Very Often

16. I have trouble with tasks where I have to come up with my own ideas. *

Never or rarely
Sometimes
Often
Very Often

17. It's hard for me to tell how well I'm doing on a task. *

Never or rarely
Sometimes
Often
Very Often

18. I have trouble reaching long-term goals. *

Never or rarely
Sometimes
Often
Very Often

19. I "go with my gut" when making decisions. *

Never or rarely
Sometimes
Often
Very Often

20. I get so wrapped up in what I'm doing that I forget about other things I need to do. *

Never or rarely
Sometimes
Often
Very Often

21. Little things frustrate me. *

Never or rarely
Sometimes
Often
Very Often

22. I have trouble getting back on track if I'm interrupted. *

Never or rarely
Sometimes
Often
Very Often

23. I have trouble making a plan. *

Never or rarely
Sometimes
Often
Very Often

24. I miss the big picture. *

Never or rarely
Sometimes
Often
Very Often

25. I live for the moment. *

Never or rarely
Sometimes
Often
Very Often

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