Wellness Coaching Questionnaire

 
 
 

Help us get to know you

There's no one-size-fits-all when it comes to feeling and living your best. Every person is different, and that's something to be celebrated! We've designed this questionnaire to help get a sense of what makes you thrive and what keeps you from doing so. Take five minutes to answer these questions and maybe learn something about yourself in the process. 

Name *
Name
Question #1
When it comes to self-care, what is your approach? Check all that apply.
Question #2
How do you feel when you have a full plate? Check all that apply.
Question #3
How often do you make time to do things you enjoy? (vacation, concerts, a favorite coffee drink, walk with the dog, etc) Select one of the following.
Question #4
What are your eating habits like? Check all that apply.
Question #5
What does "being active" look like for you? Select one of the following.
Question #6
What makes you feel the most satisfied and at peace? Select one of the following.
Question #7
What is your biggest stressor? Check all that apply.
Question #8
What is your biggest vice? Check all that apply.
Question #9
How do you feel about your space at home? Select one of the following.
Question #10
How do you feel about your space at work? Select one of the following.
What would you like to experience more of in your life? (i.e. joy, inspiration, calm, etc)