Health & Wellness Survey
1. What do you consider your biggest health and wellness challenge is right now? Choose all that apply.
Can't Focus, Scattered Attention
Insomnia/Need to sleep more frequently
Low Immune system
NOTHING! I'm Feeling GREAT!
2. What do you feel is the biggest obstacle holding you back from overcoming your pain points? Choose all that apply.
Burned out, Overwhelm
No support from friends or family
No support from a wellness or health professional
Too much conflicting information out there and don't know where to begin
Tried before and failed so afraid to attempt it again
Don't know what to eat or cook, need recipes
Know what to do, but hard to implement into daily routine
NO OBSTACLES! I'm well BALANCED!
3. What are your favorite ways to learn when it comes to your health and wellness? Choose all that apply.
Written text (PDFs, books, manuals, etc.)
One on one coaching
Live in-person workshops or events
4. What are you interested in learning? Choose all that apply.
Virtual Fitness Programs you can do at home
How to build your immune system
How to plan healthier meals/recipes/shopping lists
How to have a happy healthy gut
How to improve mindset/mental wellness
How to curb emotional eating/end cravings
How to make healthy habits stick
Tips/Tricks for self-care.
How to lose weight and keep it off
How to eat healthy on a low budget
How to make healthier meals the whole family will enjoy
Tips for kids wellness and kid friendly recipes
How to use Essential Oils
Time-saving healthy tips for busy people
How to________________ (fill in).
NOTHING! I'm a PRO!
5. What is your biggest frustration or fear when it comes to your health and wellness goals? I want to know! If you chose “other” in the answers above, you can also elaborate on those in this section.
6. Would you like to schedule a 30-minute Wellness Coaching Session with me (at no cost to you) to ask you more questions about your health and wellness challenges? I’ll also allow time at the end of our call to help you find one easy solution you can implement to help you with your health and wellness challenges.
Yes. Best time to call___________________.
No, because ___________________________.
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