Health and Well-being Snapshot
I hear in the news that people are very stressed out and anxious right now which is leading to or exacerbating health problems. Right now, the two biggest concerns for people are health and income. Do you agree? Since I am in the stress relief industry, I wonder how people are doing, how they are managing.

How are you doing in different aspects of your life? What are you doing to feel better? Is it working? What do you still need help with? I would love to hear what is going on with you. Of course, if I can help you get to where you want to go, I would be honored to assist. If you have a way to manage your stress that has been working for you, I would love to hear about it!

Sometimes just taking the time to reflect on your life is helpful. Thank you for participating!
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Email *
First Name *
Last Name *
Energy *
Morning
Afternoon
Evening
Never
My energy level is usually low during
My energy level is usually average during
My energy level is usually high during
Moods *
Rarely
Seldom
Occasionally
Frequently
Almost all the time
I'm in a bad mood
I feel just okay
I feel good
I feel great
I worry
I am fearful
I feel anxious
I have headaches *
Required
Seasonal Health Changes *
Do you have or expect to have hereditary health issues? *
Sleep Routine *
Daily
Few times a week
Few times a month
Few times a year
Rarely
Never
I feel well rested
I feel groggy
I sleep through the night
I take naps
Stress Levels *
Daily
Weekly
Monthly
Few times a year
Rarely
Never
None
Mild
Moderate
High
Very High
Crippling
What are your biggest three health challenges? *
How long have you had them? *
What techniques have you tried to alleviate your top three health challenges? *
How have these been working for you? *
If every cell in your body were able to perform at peak capacity, what would you expect to change? How long would you expect these changes to occur? *
Do you have any other thoughts about your physical health? *
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