Prioritizing You Stress Management Questionnaire
Please complete this questionnaire and you will be contacted by Erica Ferguson to set up a complimentary 30-minute phone/video call to discuss how you can live your greatest life!
Email address *
Your Name: *
Your answer
Age: *
Your answer
Location: *
Your answer
What is your job/career? *
Your answer
What is your marital status? *
Any dependents? (pets count) Please list if your dependents are children, adults, pets, etc. *
Your answer
How did you hear about Prioritizing You/Erica Ferguson? *
Your answer
What is your definition of success? *
Your answer
Describe what you value in life: *
Your answer
How many hours a week on average are you working? Does your work come home with you? *
Your answer
What would your rate your stress on a scale of feeling loss of control in your life to having a breakdown or being on the verge of a breakdown? (1-5) *
Loss of Control
Breakdown
Describe what you are stressed about. How does this stress affect your work, health and life? *
Your answer
Do you feel like you're currently burned out? If so, why? *
Your answer
Do you feel like your life has meaning and purpose? Why? *
Your answer
In what ways are you currently prioritizing yourself? (physical, mental, spiritual, emotional, etc.) *
Your answer
Finish this sentence: "I am..." *
Your answer
Any bad habits you'd like to shake? Or new habits you'd like to gain? *
Your answer
Why do you want to live a more balanced (less stressful) life? What are your motivational benefits? *
Your answer
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