Form
🌟Checking in 🌟 Support 🌟Environment“
Name
First Name
Last Name
How have you improved these past 5 to 6 weeks? What stands out most to you about your progress?
What are your goals for Optimal WELLth?
Do you prefer quick wins or slow and steady progress?”
Quick wins
Steady progress
A mix of both
What obstacle(s) stand in your way from taking the next step towards your ultimate goal (North Star 🌟)?
How do you like to be supported?
Tough love
Gentle encouragement
Both
Do the people in your life support your goals?
Always
Sometimes
Never
How do the people in your life affect your Optimal WELLth? Good and/ or Bad
What does your future self look like in 6 months from now? (Magic wand moment)
What has been your (a) bright spot & (b) biggest frustration along the last six weeks? How can I assist you in the near future?
Submit
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