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QUESTIONNAIRE

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TELL ME ABOUT YOU

Please read carefully and fill up the following questionnaire and tell me about you. Once you fill-up the questionnaire I will contact you to arrange a meeting.

Please reply honestly about the following questions regarding your physical, emotional and mental health.

It is very important in order to be able to help you during

any session or retreat.

How do you physically feel right now?Not goodSo SoGoodVery goodPerfect!How do you physically feel right now?
Do you spend time in nature?Not at allI rarely goDuring weekends & holidaysSeasonallyI live in community with natureDo you spend time in nature?
How would you rate your intimiate life??I don´t have an intimate lifeI have a poor intimate lifeI have a decent intimate lifeI am satisfied with my intimate lifeI have the perfect intimate lifeHow would you rate your intimiate life??
How do you feel emotionally?DownI have few good daysI am ok, ups & downs like everybody.I am happyI feell like a super heroHow do you feel emotionally?
How much water do you drink per day?A glass a day or lessCouple of glassesBetween 1 litre & 1.5 litres2 litres a dayMore than 2 litres a dayHow much water do you drink per day?
Are you a proactive person?Not at allIt is hard for meDepends on the matterMostlyAlwaysAre you a proactive person?
How do you feel mentally?My mind is a black cloud.I use to be very negative about life.I don´t have much time to think about anything.I am ok. Trying to figure out how to use my thoughts in a better way.I use to be very positive about life.How do you feel mentally?
Do you eat meat, chicken or fish?NoOcassionallyFew times a weekRegularly along the weekEverydayDo you eat meat, chicken or fish?
How are your interpersonal relationshipsBadIt is hard for me to communicate with othersDepends on the personMostly goodAlways goodHow are your interpersonal relationships
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