Finding the right support for you!

Getting to know each other

You have indicated you want some more support with transforming your anxiety. In order to get the best for you, I would love to know a bit more about you. When you have filled-out this questionnaire I will get in touch with you via email and we can plan your next steps together!

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* 1. What is your name (I need this to be able to know who you are!)

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* 2. What is your email address ( I need this to be able to get in touch with you)?

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* 3. On a scale from 1-10 (1 being not at all and 10 being a lot) how much impact is anxiety having on your day to day?

Clear

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

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* 4. How long have you struggled with your current challenges?

It started less than a year ago

between 1-5 years

5- 10 years

I cannot remember a life without it

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* 5. What is the biggest challenge you are facing right now?

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* 6. Where would you like to be in 3 to 6 months from now?

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* 7. Is there something you would like to share with me about yourself and your journey? (ie. mental health diagnosis; trauma; life-events - anything!)

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* 8. Are you willing and able to invest energy, time and resources to build your wellbeing and mental resilience?

Yes