Client Profiling & Quiz

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
How do you identify?* This field is required.
Please Select
Please Select
Female
Male
Nonbinary
A gender not listed here
Prefer not to say
4
What is your age?* This field is required.
Please Select
Please Select
18-30
31-40
41-50
51-65
65+
5
Have you already had or are currently in therapy?* This field is required.
YESNO
6
Have you already followed or are currently following a coaching programme?* This field is required.
YESNO
7
Do you work in the Creative Industries?* This field is required.Select one that best describes you…
Fashion
Luxury
Architecture
Media
Arts
Production
Non-Creative Industry
Other
8
What is your Profession? * This field is required.
9
Are you a creative person?* This field is required.
Yes, and I create often
No, I am not at all creative
Yes, but I do not create often
I'm not sure
I'd like to think that I am creative but not necessarily artistic
10
What is you neurological type?* This field is required.
Neurodivergent
Neurotypical
I don't know
11
What role does achievement and or success play in your overall level of contentment?* This field is required.
It's important for me
It's nice when it comes but I don't seek it
It's not important for me
12
Which one of the following options best describes how you experience success and accomplishment?* This field is required.
I feel proud and share my success publicly
I absorb it quickly then move on to the next challenge
I try to downplay it because I don't want to feel the fall after the high
I enjoy it but I anticipate that the next time I will need to do even better
I measure my success by the degree of validation from others
13
When you were a child between the age of 7-12, which statement best described your experience of the world?* This field is required.
I felt happy, calm and carefree
I felt like I could have anything I wanted if I worked hard enough
I often felt like I wasn't enough; that I could do, or be better.
I often felt different, like I couldn't connect in the same way as other children
I often felt like what I wated from life wasn't available to me
14
Which statement best describes your life so far?* This field is required.
I am truly with my life, and am excited about my future
I am happy with my life balance but, despite my success, I still feel like something is missing
I feel I have not achieved as much as I could have and I am happy with that
There are things I would like to change but they are out of my reach
If I could start over, I would do a lot of things differently
15
Which statements best describe the way you deal with stress and anxiety?* This field is required.
I go out for dinks or have drinks at home, these moments of disconnection help me
I look for escape or distraction which oftentimes involves compulsive behaviour like binge watching series, playing video games, shopping or other
I put all my focus on to something else and do it obsessively until I've worked out how to change or control the situation
I instantly feel it in my body, I quickly get physical symptoms. I often seek medical attention or I research my symptoms on line
I search for guidance or solace in my friends, family and colleagues
16
Which one of the following statements best matches your internal experience of time?* This field is required.
I spend most of my time in my present moment, I only think about the past or the future when it's strictly necessary
I try to stay in the present moment but oftentimes I think about the future
I try to stay in the present moment but oftentimes I think about the past
17
How important is change in your personal happiness model?* This field is required.
Change is uncomfortable for me, I am happier when things don't change
I change my life when it's necessary, but I don't actively seek change
I often change or seek change in people, places, and things, I feel like I grow through change and often become energised by fresh starts
I don't change often but I often fantasise about how things could be different or better
18
Do you have a clear visualisation of the future version of yourself?* This field is required.
YESNO
19
What are your current frustrations?* This field is required.
I've hit a roadblock. I want new change in my life but something’s holding me back.
I need to change my personal life or work life change but I don't know where to start.
I have to adapt to change in my life, but I'm unable to action or accept the change.
I am stuck in very unhelpful thought, feeling and or behavioural patterns. I want a better life.
I have a big event or change that I must prepare for, but I'm blocked by fear and/or procrastination.
20
Are you willing to invest over 1,000 to 4,000 Euros over the next 6 months?* This field is required.
Yes
No
Maybe
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