Pre-Session Questions
Full Name
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E-mail
*
Phone Number
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Area Code
Phone Number
What do you desire most in life? Deep down what does your heart long for?
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Tell me about the positive impact you want to make in the world?
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Which of the following do you experience?
Stress and / or anxiety
Less than amazing sleep
Struggling with unpleasant emotions / mood imbalances
Impatience / short fuse
Sub-optimal brain function (e.g foggy head, memory and concentration issues)
Exhausted / burning out
Mentally / emotionally drained
Lack of emotional bandwidth
Overwhelm
Lacking confidence, being self critical or not feeling good enough
Worrying about and being held back by what others think/say
A sense of emptiness, loneliness, disconnection or like something is missing in your heart
Seeking external things to make you feel good / over consuming e.g shopping, social media, food, alcohol, exercise
Gastrointestinal issues (e.g heartburn/acid reflux, gas, bloating, constipation, loose stools)
Other
How is this effecting you and your life? How are you being held back?
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What would life look like for you without your current challenges? How would you feel? What would you be able to achieve?
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SUBMIT
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