Name

First Name

Last Name

Email Address

Mind

How do you care for your mind? Your thoughts? Do you seek the support of a therapist, spiritual counselor or have you had a mentor in the past?

Body

How do you care for your body (daily, weekly, monthly) Energy & Happiness levels? Do you exercise? If so, what activities do you enjoy?

Spirit

In what ways do you care for your spirit? Do you have a Spiritual Practice? How much time do you spend in nature?

Lifestyle

What's your life like? What do you do for fun? What are your interests? Activities & hobbies.

Vision *

What is your vision/dream for your practice? Who are your dream clients? What is your current mission/direction?

Goals

List your top 3 business goals and anything that you feel is standing in the way of your progress.