Gut Problems Survey
100% confidential
Q1 List your gut symptoms and say whether you have a diagnosis
Q2 Which is the worst symptom?
Abdominal cramps
Constipation
Diarrhea
Bloating
Gas
Other
Q3 How true is this statement for you: Stress triggers a flare up for me
Very true
Sometimes that's true
Rarely/never
Q4 How true is this statement for you: Certain foods/drinks trigger a flare up for me
Very true
Sometimes that's true
Rarely/never
Q5 If you get stress flare ups, what sort of situations trigger these? (If none, just leave blank)
Q6 What sort of food/drink triggers a flare up for you? (If none, just leave blank)
Q7 Imagine I have a magic wand, and can make your gut issues disappear. What sort of things would you be able to do that are not an option for you at the moment?
Q8 Feel free to add any information that you think is useful in helping me understand your experience with your condition. Write as little or as much as you like.
Q9 I am looking for roadtesters to try out some free advanced stress resilience techniques (not CBT, hypnotherapy or EMDR) in return for honest feedback. Are you interested in taking part, either via coaching or self-study ?
Yes, I'd love some coaching
Yes - I'm interested in self-study but not coaching
No thanks
Q10 If you answered yes to the last question, what is your email address? (So I can send you details)
Submit
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