Live Your Destiny Survey

1. Do you have areas in your life you wish you could change? Such as unwanted behaviors, conflicts with family/friends/co-workers, money troubles, unsatisfied love relationships, career, etc.?

Do you have areas in your life you wish you could change? Such as unwanted behaviors, conflicts with family/friends/co-workers, money troubles, unsatisfied love relationships, career, etc.? Yes

If yes, what are the most important areas in your life, you'd like to change?

2. Do you currently believe it is possible for you can make permanent changes in any of these areas on your own?

Do you currently believe it is possible for you can make permanent changes in any of these areas on your own? Yes

Have you ever succeeded when you've tried? Yes or No

3. Have you ever considered working with a professional to find out why or how to resolve these issues in your life?

Have you ever considered working with a professional to find out why or how to resolve these issues in your life? Yes

4. If you have worked with a professional, what type of professional have you gone to?
Check all that apply.

If you have worked with a professional, what type of professional have you gone to? Check all that apply. Licensed Professional

Psychologist

Psychiatrist

Spiritual counselor or Pastor

Life Coach

NLP Practitioner

Hypnotherapist

N/A

Other (please specify)

5. If you worked with a professional to make changes in your life, did the changes last?

If you worked with a professional to make changes in your life, did the changes last? Yes

If yes, what did you do to make those changes last?

6. What reasons have caused you to NOT seek professional help OR have caused you to hesitate when seeking a professional? Check all the reasons that apply.

What reasons have caused you to NOT seek professional help OR have caused you to hesitate when seeking a professional? Check all the reasons that apply. Costs too much

My insurance didn’t/doesn’t cover it

Unsure of how to select a professional

I don’t have the time

I don’t believe counseling works

I don’t think I need professional help

I can figure out my own problems

People who seek professional help are mentally unstable, and that’s not me

I don’t think my issues are something a professional could help me with

It never occurred to me to seek help

Nothing stops me in seeking a professional's help

Other (please specify

7. If you learned there was a way to resolve an issue that was fast AND affordable, would you consider it?

If you learned there was a way to resolve an issue that was fast AND affordable, would you consider it? Yes

8. What advertising most influences your decisions to select a service?

	Almost always	Sometimes	Not often	Never
Radio	What advertising most influences your decisions to select a service? Radio Almost always	Radio Sometimes	Radio Not often	Radio Never
TV	TV Almost always	TV Sometimes	TV Not often	TV Never
Internet	Internet Almost always	Internet Sometimes	Internet Not often	Internet Never
Print - newspaper, magazine, flyers, etc.	Print - newspaper, magazine, flyers, etc. Almost always	Print - newspaper, magazine, flyers, etc. Sometimes	Print - newspaper, magazine, flyers, etc. Not often	Print - newspaper, magazine, flyers, etc. Never
Coupons	Coupons Almost always	Coupons Sometimes	Coupons Not often	Coupons Never
Drive by location	Drive by location Almost always	Drive by location Sometimes	Drive by location Not often	Drive by location Never
Word of mouth	Word of mouth Almost always	Word of mouth Sometimes	Word of mouth Not often	Word of mouth Never

9. On the internet, how often do you visit these social networking sites?

	Daily	1-3 times per week	1-3 times per month	1-3 times per year	Never
Facebook	On the internet, how often do you visit these social networking sites? Facebook Daily	Facebook 1-3 times per week	Facebook 1-3 times per month	Facebook 1-3 times per year	Facebook Never
My space	My space Daily	My space 1-3 times per week	My space 1-3 times per month	My space 1-3 times per year	My space Never
YouTube	YouTube Daily	YouTube 1-3 times per week	YouTube 1-3 times per month	YouTube 1-3 times per year	YouTube Never
Twitter	Twitter Daily	Twitter 1-3 times per week	Twitter 1-3 times per month	Twitter 1-3 times per year	Twitter Never