Aligning for Transformation- Simple Mapping
Thank you for choosing to align and transform. By aligning your goals, needs, and passions and working through internal blockers you can transform your life beyond your wildest dreams. Are you ready?
Please take some time to complete this form. Try not to over think it. The form is a great way to give us a head start at working together and it saves you time in a session with me.
It is not in any way mandatory, nor does it provide any standardized profiling information. This is a simple template with common discussion items that can help us pinpoint what we might want to work on, also known as trailheads. There is also an open question for any comments or questions you think might better serve your particular needs. This and everything we discuss will remain confidential.
I look forward to the opportunity to help you launch yourself into your personal success!
Phone - *remains confidential*
Best way to be reached- * no spamming*
I would like to work on:
Committing to a healthy lifestyle
Understanding and categorizing my needs
Understanding and overcoming my success blockers
Improving my relationship with myself
Relating to others successfully
Finding what works for me and flying with it!
Managing my stress
Changing my approach to my life so that I can get out of my own way.
Putting my happiness on my list of priorities.
Finding clarity about what matters to me most.
Communicating effectively with others.
What is my biggest obstacle?
How happy would I rate myself as being in this moment that I am taking action.
Usually when I set my mind on something...
I get it done very quickly.
I find obstacles.
I get disappointed.
I self sabotage.
I take my time allowing for changes.
I let things happen. If it is meant to be it will be.
I used to be so focused.
I just don't know...it's time I get it together.
I consider myself to be an
A little of both.
Choose sentences you most agree with;
I deserve to be happy.
I am fulfilling my dreams.
I feel proud of past accomplishments.
I am dedicated to getting clarity on my goals.
I am in tune with my body and immediately take care of its needs as they arise.
I connect on a deeper level with someone regularly.
I know I am capable of great things.
I have a clear definition of what success is to me.
I set goals and achieve them.
Others believe in me more than I do.
I feel stressed about my daily life.
I have recently experienced something traumatic.
I often feel anxious.
It's hard for me to accept a compliment.
I tend to want things my way.
I am hard on myself if things are not perfect.
I ruminate over mistakes.
I love being the center of attention.
I prefer team work to independent work.
I like to be in control.
Details annoy me.
I spend quiet time alone to clear my mind.
I spend hours on media and lose track of time.
I sleep 8 hours every or most night(s).
I watch what I eat.
I am often indecisive.
I don't believe in myself as much as I should.
I feel like I don't deserve to succeed.
A past failure still haunts me.
I can easily self motivate.
I am afraid of failure.
I fear success.
I am physically active.
I fear being criticised.
I enjoy hobbies.
I can be very sarcastic at times.
I watch TV every day.
I read to escape.
I enjoy personal development and learning.
I expect more of myself.
Humor is important to me.
I hold others to the same standards I hold myself.
I often feel "less than."
Being as healthy as I can be is a priority.
not something I really think about
yes but I can't seem to stick with it.
Do you have unused memberships to health facilities/classes/apps?
Do you prefer to exercise with friends, strangers, or solo?
Friends keep me motivated.
Strangers: I like to see others exercising but socializing should be optional.
I prefer to maximize my alone time.
I am embarrassed to work out in public.
I consider healthy eating a priority.
Definitely! I know how to fuel my body
I know what I should be doing but I don't always do it.
Food? I eat when I can. After all I do I deserve a good meal.
Think about the last week of meals. Do you typically eat out (count anything you do not cook)
1-2X a week
3-5x a week
7x a week or more
What is your current fitness PRACTICE. How often do you engage in any form of exercise?
1-2x per week
3-5x per week
I do something just about every day
My favorite physical activities are:
fitness class at a gym
sports (for example kick boxing, basketball, volleyball, soccer)
What are your health goals?
What has been your biggest barrier to self care?
Are you at your ideal weight? Is this a goal?
When were you most satisfied with yourself / your life?
If I could choose anything and everything to make my life perfect I would pick...
My greatest fear is that...
If I were to become my friend, qualities I would appreciate most would be...
When it comes to self sabotage I usually...
If I could be someone famous I would pick... because...
If I were my parent I would say that the child version of me is...
One thing I regret most in my life is...
The greatest thing I want to change in my life right now is...
I prefer to work with a coach
via Zoom call
Both, depending on schedule
I don't know yet.
I understand this is a coaching service that is not a replacement for therapy or medical treatment. I also understand that although results can be extraordinary and fast, they differ from person to person. If at any time I decide to stop, I can get a refund for unused prepaid sessions. If my coach feels this is not a good match, she will issue a refund for unused prepaid sessions. Please sign full name below.
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