Health

1
Before we begin your health transformation journey, may I please know your name?* This field is required.
First Name
Last Name
2
{name}, Which statement below best describes you?* This field is required.
I'm in great mental and physical health and want to maintain or optimize it.
I work on both my mental and physical state often, but I know there is room for improvement for one or both of these.
I don't spend enough time on my mental and/or physical state. I think about making changes. Sometimes I do, but I don't always stick with it.
My mental and/or physical state is not ideal at all. I'm not certain how to break this cycle, but I know it would change my life if I did.
Other
3
How do you feel about your current health and wellness journey?* This field is required.
Proud and proactive, always seeking ways to enhance my health.
Confident in my actions but looking for additional insights.
Motivated but in need of direction and support.
Overwhelmed and uncertain about where to start.
Other
4
How would you best describe what you want MOST regarding your physical and/or mental health?* This field is required.
I want to learn how to create new habits that put me in charge of both my mental and physical state.
I want my mindset to offer me more peace and happiness in my life.
I want my physical body to be completely healthy and full of energy.
All of the above.
Other
5
What do you believe is your biggest challenge when it comes to achieving your health goals?* This field is required.
Overcoming specific health issues or conditions.
Managing stress and its impact on my well-being.
Sticking to a consistent health and fitness routine.
Identifying the right dietary and lifestyle changes.
Understanding how to put my mind in control of my body.
All of the above.
Other
6
What is your primary health goal?
To overcome or manage a health condition.
To improve my physical fitness and strength.
To achieve and maintain a healthy weight.
To enhance my mental and emotional well-being.
All of the above.
Other
7
What do you believe are the potential consequences of not actively working on your mindset for better health?* This field is required.
Continued struggle with adopting and maintaining healthy habits.
Increased vulnerability to stress and its physical manifestations.
A cycle of negative thinking that further impacts mental and physical health.
Feeling disconnected from your body’s needs, leading to poor health choices.
All of the above, leading to compromised overall well-being and missed opportunities for a healthier life.
Other
8
Do you believe that employing targeted mindset tools, specifically developed to enhance both mental and physical well-being, can profoundly transform your life?* This field is required.
Yes!
I'm here to find out.
9
Submit your email below to access customized strategies for rewiring your brain to consistently manifest and maintain optimal health in your life."* This field is required.
example@example.com
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