The Core Energy Self-Assessment Template (Free Download)

You can’t refill a tank you’ve never measured. Most capable people run on empty for years without once taking an honest reading, partly because everything keeps working, and partly because the question “how am I, really?” has learned to answer itself with “fine, busy.”

This template changes that. It’s the book’s opening exercise, adapted into a worksheet you can complete in ten to fifteen minutes with a notebook or a notes app. It won’t diagnose you and it won’t fix you. It will show you, in your own handwriting, where your energy actually stands. The complete guide to high-functioning exhaustion explains the condition behind the numbers; this post is the instrument panel.

What this template measures

Not your workload. Not your fitness. Your core energy: the baseline reserve that everything else draws from, the deep supply that determines whether rest converts into life or passes straight through you.

The book describes people in this state as running on emergency reserves, the part of you that used to feel alive, creative, and connected operating on a supply that was never meant to be permanent. The seven questions below read that reserve from seven angles: your number, your autopilot, your drains, your joy, your body, your balance, and your fear.

How to use it

Three rules, and they matter more than the questions:

Radical honesty. No rounding up to be polite, optimistic, or impressive. Nobody is watching. The inflated answer only cheats you.
Kindness. Whatever shows up gets met like a friend’s confession, not a performance review. The goal is seeing, not scoring yourself into shame.
No fixing. Don’t turn it into a to-do list mid-exercise. Just look. Solutions come later, and only to people who’ve told themselves the truth first.

Find a quiet moment, ten to fifteen minutes. Pen and paper beats a phone, if only because the phone has other plans for your attention.

The template

Copy this block into your notebook and fill it in:

CORE ENERGY SELF-ASSESSMENT
Date: ____________

1. My energy on an average day right now (1 = completely drained,
   10 = vibrant, present, fully alive): ____ / 10

2. What percent of my day do I spend on autopilot vs. actually present?
   Autopilot: ____%     Present: ____%
   Times per day I think "I just need to get through this": ____

3. GIVES me energy (tasks, people, places, activities):
   - 
   - 
   - 

   DRAINS my energy:
   - 
   - 
   - 

4. The last time I felt real joy or peace for more than a few minutes:
   When: ____________  What: ____________  With whom: ____________
   How does the memory feel from where I stand now: ____________

5. Signals my body has sent in the last 3-6 months
   (sleep, tension, headaches, digestion, getting sick, flatness):
   - 

6. If my energy were a bank account, right now I am:
   [ ] deeply in the red   [ ] barely in the black   [ ] living off credit

7. If I stopped pushing and actually listened to how depleted I am,
   what I'm afraid would happen is: ____________

Answer in fragments if that’s what comes. Fragments are usually the honest part.

The closing sentence

When the seven questions are answered, say this out loud, filling both blanks:

“I am currently functioning at ___ % of my real capacity, and I’ve been ignoring it because ________.”

The book notes that most people feel a mix of relief and sadness as they say it, and sometimes the pretending stops for a moment, right there in the room. That pause isn’t a side effect. It’s the reset beginning.

How to read your score

Bands, gently drawn:

8-10: You’re resourced. Protect what’s working. This band usually doesn’t take this quiz, but if you’re here, note what’s in your Gives list. It’s the blueprint.
5-7: Running warm. You’re coping, but the margin is thin, and a heavy season could tip you. Time for one boundary and one daily refill.
2-4: Emergency reserves. This is the band where sleep stopped converting into energy a while ago, and where the split between your outer performance and inner state is widest. Small daily refills, soon, and support if this has lasted months.

Watch for the pattern the book flags in capable people: many discover they’ve been functioning at 30 to 50 percent of capacity for months or years, and that nobody noticed, including them. If your number startled you, you’re in very normal company. If you’re unsure whether you’re simply tired or truly depleted, the honest energy check interprets these answers in detail, and the tired vs. depleted question explains the science of why the two need different treatment.

What to do with what you find

The template ends, deliberately, without an action plan, because the first task is the truth. That said, here’s the direction of travel, in order:

Name one drain you can quietly shrink this week. Not the biggest one. The easiest one.
Name one item from your Gives list and schedule it, small, within seven days.
Pick a single anchor practice for the next month: a five-minute morning breath, one screen-free meal, or an evening wind-down. One. The full step-by-step version of this assessment goes deeper on each question and on choosing that first anchor.
Revisit monthly. Put it in the calendar now, same date next month. The score matters less than its direction.

If you want to keep watch between assessments, the energy audit practice shows you how to track the balance without turning your life into a spreadsheet.

Make it a monthly habit

One reading is a snapshot. Monthly readings are a trend line, and trends are what catch slow leaks. Most people who keep this up notice the same thing by month two or three: the number starts responding to small changes, which is the quiet proof that the tank can fill again. That response is also the best early warning system you’ll ever own; a dip in next month’s score shows up long before the flatness does.

Key takeaways

Core energy is the reserve everything else draws from. You can’t refill what you never measure.
Ten to fifteen minutes, seven questions, three rules: honesty, kindness, no fixing.
The closing sentence, said out loud, is where the pretending stops and the reset begins.
Read your score as a band, then shrink one drain, schedule one giver, and keep one anchor.
Monthly repetition turns a snapshot into an early warning system.

Frequently asked questions

Is this a medical assessment?

No. It’s a self-reflection exercise, not a diagnosis and not a substitute for one. If your answers point to persistent exhaustion, numbness, or low mood, bring them to a doctor or therapist. The template is a mirror, and mirrors are useful at appointments too.

How is this different from tracking productivity or habits?

Productivity tracking measures output. This measures the input nobody tracks: the reserve that makes output possible. You can be more productive than ever and running on emergency reserves, which is precisely the trap this template is built to reveal.

What if I don’t like my answers?

Then the template did its job. Disliking a reading doesn’t change it; it just proves the old “I’m fine” was doing some heavy lifting. Meet the number with the same kindness you’d offer a friend, shrink one small drain this week, and reread the closing sentence. The point isn’t the score. It’s that you finally asked.

How often should I redo it?

Monthly is the sweet spot, plus after any major season ends: a launch, a move, a hard quarter. Weekly gets anxious. Never gets honest. Once a month keeps the trend line without turning it into another job.

You’ve probably measured everything else in your life: steps, spend, screen time. This is the measurement that was missing. Quiet Core Reset takes what your answers just showed you and builds the refill plan around it, one small, kind, daily practice at a time.

This article is educational, not medical advice. If exhaustion, numbness, or low mood persists, please consult a professional.