Root to Rise Discovery Questions
The following questions are designed for me to get to know you better and to get your wheels turning so our time together is as productive and inspiring as possible. No need to answer a question if you don’t feel called to do so. Stick with the ones that feel important to you.

*Please submit this form at least 24 hours before our consultation.

Your name
Your answer
Email
Your answer
Phone Number
Your answer
Date of Birth
MM
/
DD
/
YYYY
Where do you currently live
Your answer
Relationship Status
Your answer
Children
Your answer
Occupation
Your answer
What activities make you feel alive or hold deep meaning for you?
Your answer
What do you admire about yourself?
Your answer
What goals do you have for yourself?
Your answer
At what point did you feel your best?
Your answer
How satisfied are you with your current job?
Unsatisfied
Fully satisfied
How is your sleep?
Your answer
Do you take any supplements/medications?
Your answer
Any healers/helpers/therapists with which you are involved?
Your answer
What role does movement/exercise play in your life?
Your answer
What foods did you eat often as a child? Think breakfast, lunch, dinner, snacks.
Your answer
What foods do you eat often now? Think breakfast, lunch, dinner, snacks.
Your answer
What percentage of your food is homemade?
Your answer
Do you crave sugar/caffeine/cigarettes or have any major addictions?
Your answer
Any allergies or sensitivities?
Your answer
Why are you interested in working with a health advisor?
Your answer
Anything else you'd like me to know?
Your answer
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