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* 1. Resourcefulness: In the last 12 months, how many times did you reach out for support to get care for yourself? (massage, therapy, coaching, etc.)

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* 2. Demographics: Please submit

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* 3. Struggles: What keeps you up at night?

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* 4. Clarity: What relationship are you most eager to invest time and energy into now?

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* 5. Declaration: I'm ready, willing, and able to invest in my relational health, declare my Moonshot (aim high, dive deep, and live an extraordinary life)

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* 6. Commitment: I'm committed to change in here to ignite out there. I know personal transformation is an inside job and there are things I want to be different in my environment (home, family, community, world) but it starts within. 

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* 7. Committed Action: I'm clear that writing down my intentions, stating my declarations (Moonshots), makes them more likely to happen.

0 This isn't me 50 I know this, I haven't done it up until now 100 I know this to be true in my life, 100%
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i We adjusted the number you entered based on the slider’s scale.

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* 8. Accountability: I'm aware that sharing my Moonshot with others, after writing them down, increases the likelihood they will happen

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i We adjusted the number you entered based on the slider’s scale.

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* 9. Readiness: I'm ready, willing, and able to be accountable to others and provide valuable feedback to others to enhance accountability and inspiration. We rise together

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i We adjusted the number you entered based on the slider’s scale.
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