memory-key.com

The following questionnaire, in printable format, is designed to help you think about the specific memory tasks that involve intention memory, and to help you assess your memory performance. The empty final column is for you to rank the tasks you want to improve, in priority order.

  1. In conversation with others, do you forget to bring up some point or question that you had intended to mention


never occasionally often

  1. Going to the supermarket to buy several items, do you forget at least one of them


never occasionally often

  1. When going out to do some errands, do you forget to do at least one of them


never occasionally often

  1. When taking medication, do you forget to take it at the right time


never occasionally often

  1. Do you sometimes find yourself in a place and know that there is something you meant to do there, but can’t remember what it is

never occasionally often

  1. Do you forget appointments

never occasionally often

  1. Do you forget special dates (birthdays, anniversaries, etc)

never occasionally often

  1. Do you forget promises you have made to other people

never occasionally often

  1. Think about the various people you might make promises to. How often do you forget promises made to:

your spouse/partner
your child(ren)
other close family members
friends
workmates
your boss/client


never occasionally often
never occasionally often
never occasionally often
never occasionally often
never occasionally often
never occasionally often

  1. Do you forget to return library books/videos/DVDs on time

never occasionally often

  1. Do you forget routine chores (e.g., to water your plants, to take out the rubbish, to pay bills)


never occasionally often

  1. Do you keep forgetting to do infrequent personal tasks before finally doing them (e.g., renewing a passport, making an appointment to see the doctor/dentist, stopping newspaper and mail before you go on holiday)

never occasionally often

  1. Do you forget personal goals (e.g., setting aside time everyday for some fitness/study/language learning activity, intentions to achieve some personal / home / garden maintenance goal within a certain period)

never occasionally often

  1. Do you forget work goals

never occasionally often

  1. Do you have trouble remembering ideas

never occasionally often

  1. If other people expect you to remember for them, do you forget other people’s intentions


never occasionally often

  1. Do you remember an intended action at an inappropriate time or place, and then forget it when the time / place is appropriate


never occasionally often

  1. If so, does this happen within quite short time-spans (e.g., walking from one room to another)


never occasionally often

  1. Do you forget to pass on messages / information to others

never occasionally often

  1. Do you forget to terminate actions (taking things out of the oven; turning a hose off, picking up drycleaning, etc)


never occasionally often

This isn’t the kind of quiz you pass or fail, so I haven’t provided a way to score. The object of this questionnaire is to get you thinking about your memory performance in the domain of intention memory. Part of the point of this exercise (a small part) is to demonstrate how specific details often give quite a different picture from your global impression. The main point, however, is to get you thinking about the kinds of memory tasks there are, and in particular, the kinds of memory tasks that you specifically want to improve.

Copyright © 2000-2 Capital Research Limited.
Permission is granted to copy and distribute this material in educational settings, provided that the author is advised and due acknowledgment is made of the source on any handouts.