Discovery Call Questionnaire

Answer the following questions to help me better understand where you are.

When you think about your future, how often do you feel excited and hopeful? *

Select the answer that best describes how you feel.

How satisfied are you with your Work? *

Select the answer that best describes how you feel.

How satisfied are you with your Personal Life? *

Select the answer that best describes how you feel.

How satisfied are you with your Relationships, both at home and socially? *

Select the answer that best describes how you feel.

How would you rate your Sleep Quality, Dietary Habits and Activity Level? *

Select the answer that best describes how you feel.

How often do you feel Stressed and Overwhelmed? *

Select the answer that best describes how you feel.

How often do you act according to other people's expectations? *

Select the answer that best describes how you feel.

What's the Νο 1 goal you would like to achieve? *

On a scale of 1-10 (1=min, 10=max) how commited are you to work on improving your life?

Are you currently in therapy? *

Is there anything else you would like me to know about you?

How did you learn about me? (choose) *

Name *

Email *

Phone *

Website