Finally feel BETTER!

…You’ve taken the first step, now let’s make it happen.

Writing your goals down and selectively sharing them will increase your success!

The following questions will help YOU clarify your health goals and help me support YOU with your transformation.

We all know the simple steps we can take toward becoming healthy. Things like "eat a better diet" and "exercise more". But, do we take consistent action?

What if you had access to a lifestyle system designed to help healthy people JUST LIKE YOU maintain OR improve their health?

Learn more about the "Get Better" series for women who want to experience more energy and feel better at purehealthysolutions.com. Fatigue and overwhelm are common but they are not normal.

Let’s change that!

Thanks in advance for completing this 5-minute survey!

Your privacy is important to me. Your responses are confidential - see Pure Healthy Solutions' Privacy Policy or reach out to Beth [at] purehealthysolutions.com

Question Title

* 1. If there was one thing you could do to improve your health, what would it be?

Lose weight

Exercise more

Eat healthier

Drink more water

Eat less sugar

Get more sleep

Other (please specify)

Question Title

* 2. How happy are you with YOUR health and fitness level?

Very happy

I could be more fit and healthy

I am not happy at all

Question Title

* 3. What is your BIGGEST CHALLENGE RIGHT NOW you see as a roadblock to maintaining or improving YOUR health?

Question Title

* 4. How do you currently receive information about health and well-being?

From friends or family

My doctor or other healthcare provider

Internet search

Books or magazines

Other (please specify)

Question Title

* 5. What are your top 3 goals for your health in the next 6 months?

Goal #1

Goal #2

Goal #3

Question Title

* 6. What would help you most in order to make positive changes in your health?

Education about a healthy lifestyle

Beginning an exercise program

Having a coach or accountability partner

Developing a healthy mindset

Reducing stress in my day-to-day life

Other (please specify)

Question Title

* 7. When thinking about your health, what is the number one thing you know you could be doing right now to improve your health:

Get more sleep

Get a check up from my health care provider

Improve my diet

Exercise more

Manage my stress

Other (please specify)

Question Title

* 8. Which strategies to improve your health have you tried in the past?

Meditation, visualization, affirmations, or relaxation practice.

Vegan, plant-based, gluten-free, dairy-free, or another special diet

Spending time in nature

Daily walks

Cutting out sugar, snacking, or late night eating

I haven't used tried any strategies to improve my health in the past

Other (please specify)

Question Title

* 9. How do you prefer to receive information about health and wellness?

	I prefer this	I do not like this	Not sure
In person. For example, one to one conversation.	In person. For example, one to one conversation. I prefer this	In person. For example, one to one conversation. I do not like this	In person. For example, one to one conversation. Not sure
Audio. For example, a podcast.	Audio. For example, a podcast. I prefer this	Audio. For example, a podcast. I do not like this	Audio. For example, a podcast. Not sure
Written. For example, a blog or a book.	Written. For example, a blog or a book. I prefer this	Written. For example, a blog or a book. I do not like this	Written. For example, a blog or a book. Not sure
Internet search.	Internet search. I prefer this	Internet search. I do not like this	Internet search. Not sure
Group discussion. For example, a women's only meeting.	Group discussion. For example, a women's only meeting. I prefer this	Group discussion. For example, a women's only meeting. I do not like this	Group discussion. For example, a women's only meeting. Not sure
Video. For example, Youtube.	Video. For example, Youtube. I prefer this	Video. For example, Youtube. I do not like this	Video. For example, Youtube. Not sure

Question Title

* 10. Complete this section if you're ready to upgrade your health!

You do not have to provide any or all of this information in order for your survey results to be submitted. SIMPLY CLICK DONE AT THE BOTTOM OF THE SCREEN if you're not interested in hearing more about health from me.

Thank you for participating in the survey!

Name

ZIP/Postal Code

Email Address

Phone Number