How often do you get through the day on mental cruise control?
Always Sometimes Rarely
What triggers your autopilot mode?
Stress Routine Fatigue Multitasking Other
When do you notice you are on autopilot?
Morning Afternoon Evening Night Never
How do you feel after autopilot?
Energized Neutral Drained Anxious Calm
Do you consciously break autopilot?
Yes, always Yes, sometimes No, never Don't know
Would you like to improve awareness?
Yes, definitely Yes, maybe No, not interested Unsure
All set, how can we reach you?
Name
Email
(Details here)
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    Enhance awareness daily.

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    Break free from autopilot.

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    Mindful living starts here.

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