Is Chi for Me Survey
Congratulations! You are taking THE FIRST STEP!

Is Chi for Me Survey begins the conversation and our connection. Once you’ve completed the responses, I will contact you to set up a 30-minute complimentary Discovery Call.

Please answer the question in a few sentences or less.

Is CHI For Me Survey is highly confidential and will be viewed solely by Sanna Carapellotti.
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Email *
Full Name *
Phone *
Describe your stress or anxiety in one to three sentences. *
#1: What motivated you to complete this questionnaire today? Be specific. *
#2: What do you hope to achieve if you enroll in the partnership? *
#3: Why is this a good time to resolve the struggle you describe? *
#4: What else have you tried to resolve this issue? *
#5: Do you believe that childhood and generational influences still impact your life today? *
#6: Are you willing to explore the subconscious for hidden contributors to your stress? *
#7: How often do you follow a doctor or practitioner's recommendations? *
#8: Have you ever been hospitalized for mental illness? *
#9: Are you taking medications for anxiety or depression or mental illness? *
#10: Have you ever been suicidal or attempted suicide? Explain. *
#11: What addictions do you have? Drugs, alcohol, medications, food, shopping, internet, porn? *
#12: Have you tried non-traditional healing methods for other issues in your life? If so, what have you tried? What are your thoughts? *
#13: How do you envision your life after the struggle is transformed? *
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