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Sophic Steps Health-Life-Mindset Survey
Thank you for taking the time to fill out the following questions prior to your upcoming Discovery Session. All your information will be kept confidential.
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Email
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Your email
1. What is your main health and/or lifestyle concern?
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Your answer
2. What have you done in the past to work on this concern?
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Your answer
3. What has proven effective?
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Your answer
4. What are your current eating habits? Be specific about what you generally eat, how often you eat, and what times you tend to eat.
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Your answer
5. Are you taking any supplements? Please list what take and what it's for.
Your answer
6. What would you like your health to be like 30 days from now? 90 days? One year? How will you feel if you get this result?
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Your answer
7. What obstacles, challenges, and struggles do you typically experience with regard to health and lifestyle? In other words, what's stopping you from reaching your goal(s)?
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Your answer
8. What do you hope to get out of our time together?
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Your answer
9. What are 5 things you LOVE about your life?
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Your answer
10. Please rate your current state on each of the following six key lifestyle areas on a scale of 1 to 10 (10 being best).
Physical Health
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Mental Outlook
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Social Engagement
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Spiritual Connection
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Professional Potential
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Financial Stability
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10
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