Weekly Self-Assessment

End-of-week reflection on effort, learning, and habits, with a goal for next week.

form exemplar assessment-reflection self-assessment reflection

Weekly Self-Assessment

JaxForm

Weekly Self-Assessment

This form helps you reflect on your week – what went well, what was tricky, and what you’ll focus on next week. There are no right or wrong answers, just your honest thoughts!
Your Name*
First
Last
Week of*
Select the date for this week’s assessment.
My Effort This Week*
  • 1 — Needs much more effort
  • 2 — Could have tried harder
  • 3 — Good effort
  • 4 — Very strong effort
  • 5 — Excellent, gave it my all!
How much effort did you put into your learning this week?
My Best Work
Describe something you’re proud of from this week. What made it your best work?
Something I Struggled With
What was challenging for you this week? How did you try to overcome it?
My Goal for Next Week
Based on your reflections, what’s one thing you want to focus on or improve next week?

Need a form of your own?

Create permission slips, signup sheets, and data collection forms, then collect responses online. Free to start.

Create a Form Free