Name
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First Name
Last Name
Email
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Phone
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Instagram
App Preference for Messaging
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1. Do you wake up feeling refreshed and energized most days?
2. Do you use an alarm to wake up?
3. What are the first three things you do after waking up?
4. Do you drink coffee or any form of caffeine? If so, how many cups per day and what do you add into your coffee/matcha, etc?
5. What do you generally eat for breakfast?
6. How long after waking up do you go outside?
7. How many hours per day are you sitting?
8. What are your major goals right now? (wellness, business, purpose)
9. Are you currently on a diet or wellness program right now?
10. What is your current diet? (As detailed as possible)
11. What percentage of foods you eat are organic?
12. How much do you walk per day? (amount of time)
13. Do you have mood, energy or motivation crashes during the day? If so, what time does it usually hit you?
14. What do you believe is causing your health issue(s)?
15. What finally made you realize that you wanted to make a change with your life, health and/or business?
16. List the supplements you take on a daily basis: (brand name included)
17. Have you ever completed a detox/cleanse program?
18. How many times each day do you go to the bathroom?💩
19. Have you ever had a colonic?
20. Describe your sleep quality (When do you go to bed? What do you do before bed? Do you sleep right through the night or wake up multiple times?
21. How is your posture?
22. Are you currently taking any pharmaceutical or "recreational" drugs?
23. What does your vision of perfect health for YOU, look like?
24. What type of water do you drink on a daily basis?
25. How often do you eat out at restaurants?
26. What is your travel schedule?
27. List your 5 favourite foods to eat:
28. What is your current career, and are you happy with it?
29. If you were to have your dream career or business, what would it be?
30. What are your regular physical activites?
31. How do you feel in your body right now?
32. What made you decide to start this wellness coaching program?
33. What would be the ultimate success for you to achieve by the end of the coaching program?
