Self Care Assessment 

You need to know how to take care of yourself.  
You want to feel great, look great and enjoy your life.  

Let's get started!
First name

Last name


Is it ok if I add you to my weekly email list?
(You'll get a welcome email and then one Wednesday afternoon self-care email a week -- promise)

Check all that apply. Be honest with yourself--it helps build self awareness (which is how we make change). 

What is the most frustrating struggle you still have with self-care?

Describe one health breakthrough you want to experience.  It can be mind/body/spirit.  Writing it down will make it real!

A question to help me:  What made you decide to fill out this survey?
(i.e. my Wednesday emails, a Facebook post, a video series, a referral from a friend, finally feeling like enough is enough...)

Is there anything else you'd like to share with me?

Congratulations! You're ready to take the next step. Schedule your FREE 30 minute self care strategy session with me. They are a $150 value and I only offer a few a month, so sign up today!
Schedule your session
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