Positive Visualisation Questionnaire

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

1. Does your mind feel chaotic? * This field is required.

YESNO

4

2. I have been disturbed by unwanted thoughts and feelings. * This field is required.

YESNO

5

3. Have you participated in positive visualization practice before? * This field is required.

YESNO

6

4. Would you say it’s a struggle to focus or concentrate? * This field is required.

YESNO

7

5. Can you incorporate Positive visualization into your daily routine?* This field is required.

YESNO

8

6. Are there specific goals or intentions you have set for your positive visualization sessions? * This field is required.

YESNO

9

7. Are there any specific challenges or goals you would like to address through meditation?* This field is required.Please Explain

10

8. Have you noticed any negative changes in your sleep patterns or quality of sleep? * This field is required.

YESNO

11

9. To what degree are you comfortable with silence and stillness? * This field is required.

10 Minutes

15 Minutes

30 Minutes

60 Minutes

12

10. Are there any specific areas of your life, such as relationships, work, or personal growth, that you would like to focus on through meditation? * This field is required.Please explain

13

Terms and Conditions* This field is required.