Re-Code Report | Assessment
Please answer the questions below. Your Quantum Coach will reach out to you as soon as possible to support you on your journey!
Your Full name
Your Email
Please use the same email you used to purchase your coaching offer from Quantum Mind Academy.
Your Quantum Coach
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Please Select
Anna Berger
Joyce Dickerson
Becky Salter
Daniela Dalalau
Fina Teran
Margarita Martínez
Vanessa Fernandez
Jill Cochran
Reena Kukreja
Valeria Fontana
Elisabetta Scarabelli
Kylie Smart
Eva Romanowska
Erica Kelly
Peter Matter
Tebs Sebastian
Rhonda Chiljan
Cameron Merchant
Danielle Martin
Jazzy Melhop
Vijay Singhera
Christina Perry
Ella Warchol
Gary Smart
Sharon Sessions
Annette Pieper
Heather Russo
Kirsten Gunning
Govind Cooke
Beigette Gill
Dorothea Fiert
The person your answers will be submitted to. Please choose the Quantum Coach who gave you the link to this form.
Coach Email
example@example.com
QMA Mask Assessment results
Please enter your 5 highest ranking masks from Subconscious Masks Assessment.
Which was your highest ranking mask?
-
The Sunshine
The Superstar
The Little Princess/Prince
The People Pleaser
The Superhero
The Dramatist
The Little Soldier
The Perfectionist
The Self-basher
The Grumpy Cat
The Scapegoat
The Control Freak
The Introvert
The Powerhouse
The Rebel
The Intellectual
The Designated Patient
The Comedian
The Mascot
The Cool Cat
The Surrogate Spouse
The Social Butterfly
Which was your 2nd highest ranking mask?
-
The Sunshine
The Superstar
The Little Princess/Prince
The People Pleaser
The Superhero
The Dramatist
The Little Soldier
The Perfectionist
The Self-basher
The Grumpy Cat
The Scapegoat
The Control Freak
The Introvert
The Powerhouse
The Rebel
The Intellectual
The Designated Patient
The Comedian
The Mascot
The Cool Cat
The Surrogate Spouse
The Social Butterfly
Note: just enter a mask if you got more than 50% on the assessment
Which was your 3rd highest ranking mask?
-
The Sunshine
The Superstar
The Little Princess/Prince
The People Pleaser
The Superhero
The Dramatist
The Little Soldier
The Perfectionist
The Self-basher
The Grumpy Cat
The Scapegoat
The Control Freak
The Introvert
The Powerhouse
The Rebel
The Intellectual
The Designated Patient
The Comedian
The Mascot
The Cool Cat
The Surrogate Spouse
The Social Butterfly
Note: just enter a mask if you got more than 50% on the assessment
Which was your 4th highest ranking mask?
-
The Sunshine
The Superstar
The Little Princess/Prince
The People Pleaser
The Superhero
The Dramatist
The Little Soldier
The Perfectionist
The Self-basher
The Grumpy Cat
The Scapegoat
The Control Freak
The Introvert
The Powerhouse
The Rebel
The Intellectual
The Designated Patient
The Comedian
The Mascot
The Cool Cat
The Surrogate Spouse
The Social Butterfly
Note: just enter a mask if you got more than 50% on the assessment
Which was your 5th highest ranking mask?
-
The Sunshine
The Superstar
The Little Princess/Prince
The People Pleaser
The Superhero
The Dramatist
The Little Soldier
The Perfectionist
The Self-basher
The Grumpy Cat
The Scapegoat
The Control Freak
The Introvert
The Powerhouse
The Rebel
The Intellectual
The Designated Patient
The Comedian
The Mascot
The Cool Cat
The Surrogate Spouse
The Social Butterfly
Note: if you have two or more masks (above 50%) ranking fifth, choose the one that intuitively reveals most of you
Additional questions
Please be fully honest in order to get the best results.
Drive for Achievement
What describes you best?
Overachiever
Underachiever
None of those
Health Issues (click to open)
Do you suffer from any of the following health issues?
ABDOMINAL CRAMPS
ABSCESS
ACCIDENTS
ACHES
ACNE
ADDICTIONS
ADDISON’S DISEASE
ADRENAL PROBLEMS
AGEING PROBLEMS
AIDS
ALCOHOLISM / ABUSE
ALLERGY & HAY-FEVER
ALZHEIMER’S DISEASE
AMNESIA
ANAEMIA
ANKLE PROBLEMS
ANORECTAL BLEEDING
ANOREXIA
APPETITE, EXCESSIVE
APPETITE, LOSS OF
ARM PROBLEMS
ARTERIOSCLEROSIS
ASPHYXIATING ATTACKS
ASTHMA
ATHLETE’S FOOT
BACK PROBLEMS, UPPER
BACK PROBLEMS, MIDDLE
BACK PROBLEMS, LOWER
BABY ASTHMA
BAD BREATH
BALANCE, LOSS OF
BALDNESS
BED-WETTING
BELCHING
BIRTH DEFECTS
BLACKHEADS (Pimples)
BLADDER PROBLEMS
BLEEDING
BLEEDING GUMS
BLISTERS
BLOOD PROBLEMS
BLOOD PRESSURE, HIGH
BLOOD PRESSURE, LOW
BODY ODOUR
BOILS
BONES
BONE PROBLEMS, BREAKS
BONE PROBLEMS, DEFORMITY
BOWEL
BRAIN
BRAIN, TUMOR
BREASTS
BREASTS, LEFT
BREASTS, RIGHT
BREASTS, CYSTS, LUMPS, SORENESS
BREATH
BREATHING PROBLEMS
BRIGHT’S DISEASE
BRONCHITIS
BRUISES
BULIMIA
BURNS
BURSITIS
BUTTOCKS
CALLUSES
CANCER
CANKER SORES
CARBUNCLE
CAR SICKNESS
CARPAL TUNNEL
CATARACTS
CHILDHOOD DISEASES
CHILLS
CHRONIC DISEASES
CHOLESTEROL (High)
CIRCULATION
COLDS
COLD SORES
COLIC
COLITIS
COMA
CONJUNCTIVITIS
CONSTIPATION
CORONARY THROMBOSIS
COUGHS
CRAMPS
CROUP
CRYING
CUSHING'S DISEASE
CUTS
CYSTS
CYSTIC FIBROSIS
DEPRESSION
DIABETES
DIARRHEA
DIZZINESS
EAR PROBLEMS
ELBOW PROBLEMS
EYE (Astigmatism)
EYE (Cataracts)
EYE PROBLEMS
EYE (Farsighted)
EYE (Nearsighted)
EYE STY
FAINTING
FEET PROBLEMS
FEMALE PROBLEMS
FEVERS & INFECTIONS
FIBROIDS
FINGERS (Thumb)
FINGER (Index)
FLU
GAS PAIN (Flatulence)
GREY HAIR
GUM PROBLEMS
HAND PROBLEMS
HAYFEVER
HEADACHE
HEART ATTACK
HEARTBURN (Reflux)
HEART PROBLEMS
HEMORRHOIDS
HIP PROBLEMS
HIVES
HYPERACTIVITY
HYPERVENTILATION
IMPOTENCE
INDIGESTION
INFECTION
JAW CLINCHED
KIDNEYS
KNEE PROBLEMS
LARYNGITIS
LEFT SIDE OF BODY
LEG PROBLEMS
LIVER PROBLEMS
LUNG PROBLEMS
LUPUS
MENOPAUSE
MENTAL ALERTNESS & SENILITY
MIGRAINE HEADACHE
MENSTRUAL IMBALANCE/PMS
NAUSEA
NECK PROBLEMS
OSTEOPOROSIS
OVERWEIGHT PROBLEMS
PAIN
PANCREAS
PARKINSON’S DISEASE
PEPTIC ULCER
PHLEBITIS
PILES
PLANTAR WART
PNEUMONIA
POLIO
POST NASAL DRIP
POST MENSTRUAL SYNDROME (PMS)
PSORIASIS
PROSTATE
PROSTATE PROBLEMS
PUBIC BONE
PUBIC HAIR
QUINSY
RABIES
RECTUM
RECTUM
RESPIRATORY AILMENTS
RHEUMATISM
RHEUMATOID ARTHRITIS
RICKETS
RIGHT SIDE OF BODY
RINGWORM
ROUND SHOULDERS
SCHIZOPHRENIA
SCIATICA
SCLERODERMA
SCRATCHES
SEXUAL PROBLEMS
SHINGLES
SHOULDER PROBLEMS
SINUS PROBLEMS
SKIN PROBLEMS
SORE THROAT
SPASMS
SPINE
SPLEEN PROBLEMS
SPRAINS
STOMACH PROBLEMS
STUTTERING
STYES
SUICIDAL TENDENCIES
SWELLING
TEETH GRINDING
TETANUS
THROAT PROBLEMS
THYROID PROBLEMS
TIREDNESS
TREMORS
TWITCHES
ULCERS
UTERINE PROBLEMS
VARICOSE VEINS
VERTIGO
WARTS
WEEPING
WEIGHT PROBLEMS
WRINKLES
WRIST PROBLEMS
Triggers
Which of the following experiences are currently present and/or clear triggers for you?
Relationship conflicts and arguments
Injustice or perceived injustice in society
Work-related stress
Waiting in long lines or experiencing delays
Being ignored or feeling unheard
Disagreements with family members
Frustration with technology or technical issues
Noise pollution and disturbances from neighbours
Feeling betrayed or let down by someone
Noise pollution and disturbances from neighbors
Loss of personal control or powerlessness
Physical pain or discomfort
Rude or disrespectful behavior from others
Unmet expectations or broken promises
Being Ignored
Disrespected
Controlled
Confined at Work
Surrounded by Lazy People
Overthinking
Hyper Vigilant
Social Overload
Overwhelm
Time Pressure
Fear of Authority
Being Told What to Do
Not Feeling Smart or Intelligent
Being Objectified
People who rush me
People who have big egos
Unauthentic people
Fat people
Rude people
Needy people
Large personalities
Introverts
Foreigners
Narrow-minded people
People who talk too much
People who do not communicate
Being guilt-tripped
Being Judged
Being Corrected
Show Ponies
Being Second Guessed
No motivation
Problem with Confidence
Money problems
Relationships & Social Dynamics
Which of these attributes and behaviours describe you the most?
Relationships on the shorter side; very independent; feeling suffocated by intimacy; sabotaging blossoming romance; often first one to walk away from relationship
Craving connection and fearing loss; lower self-esteem; jealous; needing a lot of attention or reassurance from partner; clinging; tendency to idealising partner
Craving connection and affection but very uncomfortable with it; both, strong people pleasing and avoiding the partner; lashing out unpredictably
In a committed intimate relationship would you prefer your partner to act from more feminine or more from masculine energy? (We consciously don't prompt you with more information, so please go with your intuition here.)
I'd prefer MY PARTNER to act from feminine energy
I'd prefer MY PARTNER to act from masculine energy
I'm not sure at all and will bring this topic to my Quantum Coach
Verification
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