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What is your #1 Health and Happiness
Interference Factor?
Name
*
First
Last
Email
*
Are you a man or a woman?
Man
Woman
Age range?
Under 20
20-30
30-49
49-64
65+
As a [woman, age 30-49], which of these health categories is something you enjoy
Trying new recipes or cleanses
Being outdoors
Taking part in exercise challenges
Reading self-improvement or health related books
Taking part in health activities with friends (cooking classes, group hikes, etc).
As a [woman, age 30-45], which of these categories is something you enjoy the LEAST?
Trying new recipes or cleanses
Being outdoors
Taking part in exercise challanges
Reading self-improvement or health related books
Taking part in health activities with friends (cooking classes, group hikes, etc).
While you might think that you need some improvement in each of the following categories, which do you feel you need to improve MOST?
My nutrition
My Exercise routine
Creating healthier and happier mindset
Making my personal health a priority above my other daily demands
Being consistent with health strategies I already know how to implement
While you might think that you need some improvement in each of the following categories, which do you feel you need to improve MOST?
My nutrition
My Exercise routine
Creating healthier and happier mindset
Making my personal health a priority above my other daily demands
Being consistent with health strategies I already know how to implement
What is the main reason you have not taken more action toward My nutrition
I don't have enough time
I don't have enough money
I don't know how to implement these strategies in my daily life
I don't know how to stay motivated with what I already know how to do
I get overwhelmed and never actually get started
Rate your personal health on a scale of 1-10
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10
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