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tell me about you
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1.
Question 1.
Email address
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- Required.
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2.
Question 2.
Age group
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- Required.
Under 18
18-21
21-25
25-30
30-35
35+
3.
Question 3.
Tell me about your current life , habits , day to day?
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4.
Question 4.
What do you struggle with the most in your daily life?
Required
- Required.
Having a routine
Working out
Feeling unloved , not worthy enough
Anxiety getting the best of me
Overthinking
Feel unmotivated
Eating patterns
5.
Question 5.
Do you have any idea what might trigger this?
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6.
Question 6.
On a scale of 1-10 how much does this make your day to day life hard?
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- Required.
1 of 10 - 1. Select to start reordering
1
2 of 10 - 2. Select to start reordering
2
3 of 10 - 3. Select to start reordering
3
4 of 10 - 4. Select to start reordering
4
5 of 10 - 5. Select to start reordering
5
6 of 10 - 6. Select to start reordering
6
7 of 10 - 7. Select to start reordering
7
8 of 10 - 8. Select to start reordering
8
9 of 10 - 9. Select to start reordering
9
10 of 10 - 10. Select to start reordering
10
Reset order
7.
Question 7.
Can you tell me the last time you truly felt good about yourself , if so what was this? What were you doing?
8.
Question 8.
When was the last time you felt you could conquer anything in life?
9.
Question 9.
Do you feel there is anything you could do to change right now to make you feel alive and happy every day?
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10.
Question 10.
Would you love to find ways that you could implement every day to make you love yourself & be doing the things you love ?
Required
- Required.
Yes
No
Maybe
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11.
Question 11.
Which of the following would help the most?
Required
- Required.
1-1 coaching
Group coaching
Online chat
Facebook group
Journal
Digital workbooks
Self help books
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12.
Question 12.
What made you choose the above answer?
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- Required.
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13.
Question 13.
If you could make your own self help book or coaching what would you all like to have in it?
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- Required.