Anxiety Awarness Survey

Anxiety Awareness Survey

Please take a few minutes to tell us more about you and your preferences
10 lucky survey participants will be chosen to receive a free 30-minute one-on-one clarity call with Prathit Kumar, an emotional intelligence and mind coach.
Name

First NameLast Name
Email Id
example@example.com
WhatsApp Number

Country CodeMobile Number
What is your gender?
What is your age range?
Have you ever felt anxiety?
How often do you acknowledge your anxiety?

1

2

3

4

5

6

7

8

9

10

1 is Not All Often, 10 is Extremely Often
What do you feel during the anxiety episode?
Do you think anxiety can be cured?
If yes, have you tried anything?
If yes, please tell what all have you tried
Which of the following parameters would influence your decision to join an anxiety healing program?
If I provide you with a complete solution, how much are you willing to pay to get rid of anxiety?
What type of coaching would you prefer?
What are your interests? (Select all that apply) (Optional)
Celebrities/ Influencers that you follow. (Optional)
Celebrity/ Influencer 1
Celebrity/ Influencer 2
Celebrity/ Influencer 3
Thank you for investing your precious time reading and filling out this form.
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Anxiety Awareness Survey