First Contact Questionnaire

To make our upcoming call or session the most productive and valuable possible, please kindly fill up this questionnaire and click on the send button before our meeting.

You may save your answers and finish writing them at a later date. To do so, just scroll down to the bottom of the questionnaire and click on save.

Looking forward to talking to you soon.


  • meal plans, therapy, journaling...
  • Have you identified specific blocks, situations, events that make it hard for you to break free?
  • What impact will this have on your well-being, health, life, relationships, career, finances...?
  • or how do you feel when you do?
  • How would it change your life? Why is that important?
  • Was there a specific event, epiphany, or reason?
  • Please enter your name so that I know who answered this questionnaire and can prepare for our upcoming call.
  • Please tell me your age so that I can better understand your situation.