Fourth Step Inventory Worksheet Form
Complete this worksheet to thoughtfully record and reflect on your fourth step inventory. Please provide honest and detailed responses for each section.
Date of Incident
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Person(s) Involved
*
What Happened? (Brief Description)
*
Nature of the Issue
*
Please Select
Resentment
Fear
Harm to Others
Self-Seeking
Other
Feelings Experienced
*
Anger
Fear
Hurt
Guilt
Shame
Jealousy
Other
My Part or Contribution
*
Defects or Motivations Involved
*
Selfishness
Dishonesty
Self-Seeking
Fear
Pride
Envy
Other
Actions Taken
*
Consequences or Outcomes
*
What Did I Learn or How Can I Grow?
*
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