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Illuminating the Deeper You
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Date *
Name *
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Birthdate - change the year to your birth year *
Birth Place & Time *
Select the row of words that best describes you *
Check box if your answer is Yes. *
What are your Ten Defining Moments?
In every person's life, there have been moments, both positive and negative, that have defined and redefined who you are. Those events entered your consciousness with such power that they changed the very core of who and what you thought you were. A part of you was changed by those events, and caused you to define yourself, to some degree by your experience of that event.
# 1-10 *
What are your Seven Critical Choices?
There are a surprisingly small number of choices that rise to the level of life-changing ones. Critical choices are those that have changed your life, positively or negatively, and are major factors in determining who and what you will become. They are the choices that have affected your life up to today, and have set you on a path.
#1-7 *
Who are your Five Pivotal People? What reason are they pivotal?
These are the people who have left indelible impressions on your concept of self, and therefore, the life you live. They may be family members, friends or co-workers, and their influences can be either positive or negative. They are people who can determine whether you live consistently with your authentic self, or instead live a counterfeit life controlled by a fictional self that has crowded out who you really are.
#1-5 *
10 Crucial Questions Your Doctor Should Ask You (But Probably Doesn’t)
1. What is your body saying no to? *
2. What does your body need in order to heal? *
3. What’s out of balance in your life? *
4. Do you feel like you’re in touch with your life’s purpose? *
5. Are you lonely? *
6. Do you feel sexually satisfied? *
7. Do you feel depressed, anxious, or frequently afraid? *
8. Are you an optimist or a pessimist? *
9. Do you often feel helpless? *
10. Do you believe in a Higher Power? *
Looking At The Future
How committed are you to improving your life? *
Not At All
100% Committed
How strongly do you believe your life can improve? *
Not At All
What are your priority challenges you would like to work on in the coming three months? List up to three. *
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