Health and Wellness Coaching Survey

 

1. Gender: *

 

2. How old are you? *

 

What is your biggest health concern (or goal)? *

 

3. What would mean to you to achieve your desired goal or to solve your problem? *

 

4. If you could have anything from a health coach what would it be? *

 

5. How would you most like to work with a health/wellness coach? *

 

6. In what areas would you hope to benefit while working with a health/wellness coach?
(Choose AS MANY as you would like, or add one of your own!) *

 

How much time would you be willing and able to put aside a week to achieve this goal? *

 

7. Is there anything that would stop you or has stopped you seeking assistance from a health/wellness coach?
(Choose more than one if it applies to you, or add one of your own!) *

 

8. What have been some of the obstacles to participating in a healthier lifestyle (check all that apply) *

 

9. How much money would you be willing to invest in total to reach your Health and Body Goals? *

 

10. What would be the best way to let you know about the new coaching program, if it is made available (check all that apply)? *

 

11. What do you think would be the ideal number of sessions that you would like to speak with a health coach over a period of one-year?
(This is to give us a better understanding of your perspective). *

Use our survey software to make a survey.