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* 1. How old are you? 

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* 2. You identify your gender as ______.

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* 3. The top 3 worries that keep you awake at night are:

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* 4. Which of the following social media sites do you use on a regular basis? (Check all that apply)

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* 5. Do you consider yourself to be in a state of transition in your life? If yes, what are you transitioning from and what are you transitioning into? 

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* 6. In 5 words or less, what would feel like a miracle in your life right now? 

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* 7. How do you prefer to learn new things? (select all that apply)

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* 8. Your top 3 favorite blogs or websites are: 

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* 9. Your top 3 favorite Facebook Pages are: 

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* 10. Thank you for taking my survey! If you would like to be entered into a giveaway for a free transformational hypnotherapy session with me, please enter the following information below. (Your information won't be used in any way other than to enter this giveaway. The winner will be notified on October 15th.) 

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