Men's Transformation Application

1

First Name

2

Name* This field is required.

First Name

3

Email* This field is required.

example@example.com

4

Country* This field is required.

5

I use a harsh, critical tone with myself. Putting myself down and being my own worst critic.* This field is required.

Almost Never

Sometimes

Often

Almost Always

6

Would you consider yourself a creative person?* This field is required.

YESNO

7

Would you consider yourself a sensitive person?* This field is required.

YESNO

8

How often do you find yourself lost and captured in thought? This can be replaying events of the past or worrying about the future.* This field is required.

Almost Never

Sometimes

Often

Almost Always

9

I feel like I have to earn rest and relaxation through constant achievement or productivity.* This field is required.

Almost Never

Sometimes

Often

Almost Always

10

My internal voice shames, judges and criticizes me* This field is required.

Strongly Disagree

Disagree

Agree

Strongly Agree

11

How often do you feel 'behind' in your life compared to others?* This field is required.

Almost Never

Sometimes

Often

Almost Always

12

How often do you feel that no matter what you do, it's never quite enough?* This field is required.

Almost Never

Sometimes

Often

Almost Always

13

How often do you experience physical symptoms of stress, such as jaw clenching, headaches, or tightness in your neck and shoulders?* This field is required.

Almost Never

Sometimes

Often

Almost Always

14

I feel like if I had more control over my thoughts I would be happier and less stressed.* This field is required.

Strongly Disagree

Disagree

Agree

Strongly Agree

15

My life would genuinely be better and more enjoyable if I really liked myself.* This field is required.

Strongly Disagree

Disagree

Agree

Strongly Agree

16

Are you currently employed or have steady income?* This field is required.

YESNO