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People-Pleasing & Boundary Self-Check for Adults: 30 Items, Fillable PDF

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Highlights

Notice where people-pleasing costs you time, energy or self-respect—and choose one small boundary to practice. The People-Pleasing & Boundary Self-Check is a 12-page fillable and printable PDF for adults, created by Raymond Navarro, MS, LMHC.

This is a reflective educational workbook, not a validated psychological test or diagnostic assessment. Its scores are prompts for personal reflection, not clinical results.

WHAT YOU RECEIVE
• One 12-page PDF with 78 fillable fields
• A 30-item self-check across five areas: saying no; guilt and fear of disapproval; overexplaining; overcommitment and self-neglect; and boundary follow-through
• Manual domain scoring and a personal Boundary Profile
• A boundary cost check for time, energy, relationships and other everyday costs
• A seven-day experiment with a short practice log
• A boundary ladder from pausing to disengaging
• References, safety information and clear use limitations

HOW TO USE IT
Reflect on the past four weeks, notice your recurring patterns, then choose one manageable situation for a seven-day experiment. Add your scores yourself; this PDF does not calculate them automatically. Type into the fields with a compatible PDF reader, or print the US Letter pages (8.5 × 11 inches) and write by hand. Save a small test entry before filling out the full document. Compatibility can vary by device or app.

DIGITAL DELIVERY
This listing includes ONE PDF only. No physical item will be shipped. After payment is confirmed, download through Etsy in a web browser under Purchases and reviews. Etsy's app does not support digital-file downloads. Guest buyers receive a download link in the Etsy receipt email.

CHOOSE YOUR RESOURCE
This Self-Check helps you notice patterns and plan one small experiment. For a broader guided resource, see the People-Pleasing & Boundaries Reset Workbook in the Navarro Therapy shop. For ready-to-adapt wording, see 50 Boundary Scripts for People Pleasers. Those resources are sold separately and are not included in this listing. You can use this Self-Check on its own.

IMPORTANT LIMITATIONS
For adults 18+ and personal educational use. Not therapy, diagnosis, treatment, crisis care, or medical or legal advice. Purchase does not create a therapist-client relationship. When boundaries involve threats, coercion or abuse, prioritize safety and individualized support rather than confronting someone. The PDF includes crisis and relationship-safety resources. Personal use only; do not resell or redistribute.

Filename: People_Pleasing_Boundary_Self_Check_Fillable.pdf

CREATION PROCESS
Developed with AI assistance and reviewed and approved by Raymond Navarro, MS, LMHC.

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