Self-Questionnaire
In the Name of Allah, The Most Merciful, The Most Compassionate.

Peace be upon you, Beloved.

Filling out this Self questionnaire is a no-pressure, no-commitment process. 

This questionnaire is for you to, without judgment,
  • Connect with your current Self.
  • Open your heart to the future Self you aspire to be.
  • Identify the gap between your current and desired future Self.
The accompanying complimentary call, should you want to schedule one, will focus on the steps to become your desired Self that are right for you, in sha Allah.

Beloved Muslimah Coaching is a hybrid personalized coaching experience (1+1 Private Coaching and Mentorship) to support Muslim women in doing the inner work needed to cultivate a life filled with peace, confidence, and love.

Allah ﷻ tells us in His Quran,

 إِنَّ ٱللَّهَ لَا يُغَيِّرُ مَا بِقَوْمٍ حَتَّىٰ يُغَيِّرُوا۟ مَا بِأَنفُسِهِمْ

"Verily Allah does not change a people's condition unless they change their inner selves."
Surah Ar-Rad, Ayat 11

This is for you even if; 
> you are single Muslim woman seeking love but not meeting the right one.
> you are healing from a heartbreak.
> you are not fully confident in yourself and feel you have a low self-esteem.

With peace and love,
Bint Hawa

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Email *
What inspired you to fill out this questionnaire?
 *
What's your age group? *
What's your current work status? *
When did you move to the West ( i.e. the United States, Canada; the countries of the European Union plus the UK, Norway, Iceland and Switzerland; Australia and New Zealand).  *
What is your current relationship status? *
Which three relationships do you want to nourish most in your life right now? (multi-select) *
Required
Do you know meanings of the duas and surahs in prayer?   *
Required
What comes to your mind first when you hear the term love? *
What’s missing from your life that you can’t let go of?  The thing you wish would happen or do that keeps tugging at your heart.
 *
What are your biggest fears or struggles when it comes to achieving your life goals? 
 *
What have you tried doing to become the woman you want to be that worked or didn't work for you?
 *

In a year, envision your best self. What came to your mind first? 

 *
Your first and last name. *
Current Location (State/Country) *
I will be in touch, in sha Allah.

With peace and love,
Bint Hawa
A copy of your responses will be emailed to the address you provided.
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