Welcome to the World of Self-Care
Hello and welcome!
This is where I gather some information to see if and where I can help you begin to make the changes you'd like to make. Here's how this works :
1. Fill out the questionnaire below.
2. Please be as honest and candid as you can.
3. Press submit and I will be in touch within 24 hours if during the week and within 48 yours if on a weekend about what I see and if I believe I can help you move closer to your goals.
If you already have an area you know you'd like coaching and guidance in ( nutrition skills, motherhood skills,movement or mindset) please send me a message directly through facebook messenger or an email at mamaonamissioninfo@gmail.com and I will be in touch with information and questions specific to that area.
Thank you. I look forward to speaking with you!
Email address *
Name, current age and birthday *
Your answer
Best email address, physical address, best phone number to reach you and the time of day you are most likely to be available. *
Your answer
Relationship status and children ( number and ages if you have them please) *
Your answer
What are your current priorities in your life right now? What is most important to you? Please list them in order of importance. *
Your answer
What does successful self-care mean and look like for you? What activities or actions need to be included for you to be the best version of you? ( include what you feel you need to be healthy in any or all of the areas : mentally, physically or spiritually.) *
Your answer
Times in the past when you have felt your best physically were when you were.....( please describe what you were doing in your life to feel good and what it was) *
Your answer
Times in the past when you have felt mentally and emotionally at your best were when you were ..... ( please describe why you felt good at that time and what you were doing) *
Your answer
Times you have felt your most confident, happy, and satisfied with your life and who you are as a person where when.... ( describe why you felt good about yourself at that time and what you were doing) *
Your answer
What are your biggest challenges or obstacles to making self-care a consistent part of your life?
Your answer
What would you say your current stress level is on a scale of 1-10, with 10 being you could stab someone soon for no reason and 1 being as relaxed as a sock laying on the ground.
How many hours of sleep do you get per night?
When things are not going as planned and are rough for you, what kinds of things do you tell yourself?
Your answer
When things are going well and you feel good, what kind of things do you tell yourself?
Your answer
What are you specifically hoping to accomplish through this coaching process? What are your goals?
Your answer
How would you be different in self-care was a regular part of your life, instead of a luxury. What would you do or say differently?
Your answer
Why is now the right time for you to make changes?
Your answer
Please share anything else you think would be helpful for me to know about you. :)
Your answer
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