Higher Health Course Registration

Higher Health is calling you!

I will help guide you in how to take your health to the next level in body, mind, and soul!

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* 1. Congratulations on taking steps to Higher Health. What is your contact information?

Name

Address

Phone number

Who referred you?

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* 2. What are you planning on doing this year to improve your life, habits, relationships, career, wellbeing, and joy?

Doing this course

Starting an Exercise Program

Reading books related to improving health in body, mind, or soul

Creating habits for consistent improved exercise and movement in your life

Eating healthier

Journaling

Meditating

Getting better sleep

Lowering stress

Spending more time in Nature

Making time for your own self-care and play

Other (please specify)

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* 3. What are your top 3 health goals? (physical, mental, or spiritual)

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* 4. What are your deepest desires? What do you most want?

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* 5. What is the biggest challenge here for you now?

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* 6. What would you like to improve?

Sleep

Nutrition

Exercise

Calmness and Peace

Connected relationships

Energy level

Healing

Doing what you want to do

Prosperity

Overall health in your body

Release fear, doubt, anxiety, or limiting beliefs

Migraines

Back pain

Joint pain

Cancer

Autoimmune disease

High Blood Pressure

High Cholesterol

Heart problems

Stomach or digestive issues

Boosting your immune system

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* 7. Do you have any health issues? Please explain in more detail what is bothering you.

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* 8. What are your unique gifts to offer this world? (Hint: What do you love to do? What do you do that feels so exhilarating? What lights you up? What do you do and time stands still?)

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* 9. What method are you using to invest in yourself? Investing in you is the best investment you can make. I am so glad you are committing to your health. Check 2 boxes below.

I am paying in full $1299.00

I would like pay monthly- 3 payments of $483 for total of $1449.00.

I would like to chat about another payment plan

check, - send to Vibrant Health Evolution 3606 E Avondale Dr. Cottonwood Heights, UT 84121

credit card - paypal - I will send you an invoice (3.5% charge)

venmo app (same as check or bank transfer), I will send request or go to winslowpassey@winslow-passey

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* 10. Are you interested in any of the following?

Yoga & Trekking adventure in Nepal

Soul Sister Retreat

Other adventures - ski, rock or alpine

Learning about your body type

Additional 1-1 coaching

Wild edibles hikes

Whole Foods night at my house

Supplements

Yoga at my house in Cottonwood Heights

Online Yoga, Workout, and Meditation classes

Other (please specify)