MINDSET EVALUATION QUESTIONNAIRE

Name

First Name

Last Name

Email

You are aware that something(s) is not working to your benefit and are ready to make a change. This is brave!!

Please share with me what you think is holding you back at this time.

Change takes time, work and consistency. However, as you move through this process, we will approach the change in ways that are not overwhelming.

Please share with me what a typical day in your life is like. This can include details about work, meals, self-care, exercise, family, etc.

While we know the overall goal is to transform your life into alignment, what other milestones would you like to achieve? Are there specific goals you have for your physical, mental and spiritual bodies?

Please share them with me. No goal is too big or too small.

Congratulations on taking the first step toward gaining wellness and balance in your life. The form below is designed for you and me to better understand where you are in your life. Then we can start the work of transforming your life into alignment.

Book Your Body Free Consultation [15 Minutes]

I am so honored that you have chosen me to help you on your journey to balance and wellness. I promise to be there as you need me and guide you through everything. I ask that you do the same. You must show up for yourself. Give yourself the gift of your time and energy.

Together we will affect powerful and meaningful change.