Name
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First Name
Last Name
How many hours of nightly sleep do you get on average? Is your sleep routine regular?
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How much exercise (any intentional physical movement) do you engage in on average?
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What types, how often, & for how long.
How much time do you spend outside?
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How much water do you drink per day?
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Do you consume caffeine? If yes, how much per day?
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What's your relationship with food & your diet?
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What medications, supplements, and/or recreational substances do you consume? How much & how often?
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Tell me anything else I need to know about your holistic health situation.
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Physical, mental, emotional, spiritual, environmental health
What are your primary stressors? And what do you currently do to reduce stress?
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Describe any significant patterns in your relationships that you'd like to evolve.
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Intimate relationships, family, friends, work, etc.
What are some beliefs that guide or support you?
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Spirituality, mindset, etc.
What part of yourself, if any, feels unlovable?
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What are your greatest strengths? What are some things that make you special?
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What are your major weaknesses? What areas of your life could use some more harmony & alignment?
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What's your big vision? What do you dream of creating?
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Don't hold back here!
Let's say you woke up tomorrow and have all of that. What would having that do for you?
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How would you feel? Who would you be?
What is currently in the way of bringing your vision to life? What's holding you back?
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What might you have to change or give up in order to bring your vision to life? What might you have to risk?
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Please list 1 to 5 health/life goals (in alignment with your big vision) that you would like to attain for yourself within the next year, in order of priority:
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Let's say working together is worth 10x what you're paying. It's a 11/10 experience. What would make it undeniably worth the time, money, & energy you invested?
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Anything else you'd like me to know about yourself before we get started?
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