Men's Transformation Application

1

Name* This field is required.

First Name

Last Name

2

Country* This field is required.

3

Email* This field is required.

example@example.com

4

Are you currently working full-time? 40+ hours a week

YESNO

5

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

6

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

7

I use a harsh, critical tone with myself that I would never use with a close friend or family member.* This field is required.

Almost Never

Sometimes

Often

Almost Always

8

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

Strongly Disagree

Disagree

Agree

Strongly Agree

9

Do you find it difficult to be proud of yourself and celebrate your accomplishments?* This field is required.

Almost Never

Sometimes

Often

Almost Always

10

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

Almost Never

Sometimes

Often

Almost Always

11

How often do you feel that everyone else has their life figured out except you?* 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

What made you decide to pause and look at yourself more closely today?* This field is required.

14

When it comes to your mental and emotional well-being, what’s the most important change you want to experience?* This field is required.Optional

15

Select any therapeutic modality you have tried.* This field is required.

Emotional Focusing/Felt-Sense Awareness

Mindful Self-Compassion

Parts Work/Internal Family Systems (IFS)

Polyvagal Theory

Mindful Based Stress Reduction

16

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