First Name
Last Name
Email Address
 
How important is exercise in your daily routine?
 
How stressed out are you right now?
 
What does your diet look like?
 
How often do you get a little “me” time in your life?
 
Who makes up your “tribe” or support network?
 
If I raided your fridge, what’s the first item I would see?
 
What does work-life balance mean to you?
 
How much sleep do you get each night?
 
How many to-do’s have you checked off your bucket list?
 
On a scale of 1-10, with 10 being the highest, how would you rate your happiness?

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