Support Questionnaire

Salaam,

Thank you for reaching out and for your courage in taking this important step. 
Please take a few moments to complete the brief questionnaire below. Your answers will help me understand your situation and guide you in the best way possible.

Everything you share is completely confidential, and there’s no right or wrong answer — just your honest thoughts and feelings.

I look forward to learning more about you and In Sha Allah supporting you on your journey.

Maryam Yousaf
@muslimatoday


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Please provide your name and email address:
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Please share your WhatsApp number and Instagram handle.
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What country do you currently reside in?
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What areas in your life do you feel stuck in right now?
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What are the top three challenges you're facing at the moment?
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What is your main reason for seeking support, and what are the 3 goals you would like to achieve over the next three months?
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What would your life look like if everything was resolved, and what would your life look like if nothing changed?
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What is currently preventing you from solving your challenges on your own?
What do you expect to gain from my help?

What is your preferred method of contact?

Instagram DM

Email

WhatsApp

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I’d love to offer you a free 15 minute Clarity Chat to explore solutions and next steps. I’ll contact you via your preferred method to arrange a time that works best for you. Please share your preferred day and time (Monday to Friday, 10:00 am – 7:00 pm UK time). 
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Where did you hear about me?
Date completed form:

If you have any questions, please email askmuslimatoday@gmail.com or comment below.

JazakAllah Khair for completing this form! I will get back to you soon, In Sha Allah. 


Warm regards,
Maryam Yousef
Marriage & Mindset Coach 

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