Take A Wellbeing Snapshot ✨

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Feeling curious about your well-being?

Want to explore ways to boost your energy, sleep better, or simply feel more vibrant?

This quick survey helps me understand your priorities so I can offer personalized tips and support.

Plus, get a FREE E-book on Gut Health & Immunity as a thank you!

Email *

Full name *

What are your top priorities for your wellbeing right now? (Select all that apply) *

Increased energy levels

Improved sleep

Healthier eating habits

Stronger immunity

Supporting the wellbeing of my family

Weight management

Option 7

Required

If weight management is a priority, what's your goal?

Maintain my current weight

Lose 2-5kg

Lose 5-10kg

Lose 10-15kg

Lose 20+kg

Clear selection

What's been your biggest challenge in achieving your wellbeing goals? (Select all that apply) *

Finding the motivation

Fitting in exercise

Eating healthy

Balancing work/life/family commitments

Lack of time

Other:

Required

How would you describe your current energy levels? *

Low, I often feel tired and sluggish

Moderate - I have energy during some parts of the day but often experience dips

High - I feel energised and ready to go most days

What resonates most with you? (select all that apply) *

I often feel run-down

I experience frequent illness

I regularly have aches and pains

My family members frequently get sick

I'm concerned about my hair or nail health

I struggle to manage stress effectively

I want to make positive changes, but don't know where to start

I've tried many different things without much success

I experience the yo-yo effect with my weight

Required

On an average day, how many healthy meals do you typically eat? *

3 or more

I often snack instead of eating full meals

I find it challenging to make healthy eating a priority

Required

How many servings of fruits & vegetables do you eat daily? *

0 - 3 servings

3 - 6 servings

7+ servings

How important is achieving your wellbeing goals to you? (Rate on a scale of 1-5, with 5 being the highest) *

What kind of support would be most helpful to you? (Select all that apply) *

Quick and easy healthy recipes

A simple workout plan (gym or at-home)

Personalised guidance and support

A motivating and supportive community

Recommendations for supplements

Required

Would you like a copy of our E-book on Gut Health & Immunity?

Yes

WhatsApp Number *

Thank you so much for filling out this form for me!

Please save this email address: steph@movementwithsteph.com.au as you'll hear from me via email within the next 48 hours✨

A copy of your responses will be emailed to the address you provided.

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