How satisfied are you with your current health and wellness?
Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied
What areas of health and wellness do you prioritize most?
Physical fitness Nutrition Mental health Sleep quality Stress management
How often do you engage in physical activity per week?
Daily 3-4 times per week 1-2 times per week Occasionally Rarely
Which wellness practices are part of your daily routine?
Meditation Yoga Healthy eating Journaling Regular check-ups
What motivates you to maintain a healthy lifestyle?
Weight management Overall well-being Energy levels Disease prevention Personal fulfillment
Do you seek professional guidance for your health and wellness goals?
Yes, regularly Occasionally No, I prefer self-management Not currently, but considering No, I rely on online resources
All set, how can we reach you?
Name
Email
Phone
(Details here)
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