You can always press Enter⏎ to continue
Welcome to Levana
Thank you for being here ♡ This form helps us ensure a good fit for both parties. We'll use your answers to tailor our Fearless Wellbeing program to your specific needs.
20
Questions
START
1
Name
First Name
Last Name
Previous
Next
Submit
Press
Enter
2
Email
example@example.com
Previous
Next
Submit
Press
Enter
3
What is your age and gender?
Previous
Next
Submit
Press
Enter
4
What is your current occupation and educational background?
Previous
Next
Submit
Press
Enter
5
What motivated you to seek emotional intelligence coaching at this time?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
6
Have you previously participated in any mental health programs or therapy? If so, what was your experience like?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
7
Can you describe any current challenges or issues you are facing that you hope to address through coaching?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
8
How would you describe your current mental wellbeing and emotional intelligence?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
9
What specific goals do you hope to achieve through this coaching program?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
10
How do you envision the coaching process helping you reach these goals?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
11
Are there any particular skills or areas of focus you are interested in developing?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
12
How ready do you feel to make changes or work on your emotional intelligence at this time?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
13
How much time are you able to commit to the coaching sessions and related activities each week?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
14
Are you open to trying new strategies or approaches to improve your emotional intelligence?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
15
Do you have a support system (family, friends, colleagues) in place? If so, how do they support you in your mental health journey?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
16
Are there any specific accommodations or considerations that would help you succeed in this program?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
17
Have you used any coping mechanisms or strategies in the past? Which ones have been effective or ineffective for you?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
18
Are there any particular methods or techniques you are interested in exploring through this coaching program?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
19
Do you have any concerns or questions about the coaching program that you would like to discuss?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
20
Is there anything else you would like us to know that might help us tailor the program to better meet your needs?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
20
See All
Go Back
Submit
.66cf929c050023.14128728.png){kind=logo}