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Elements Healing & Wellbeing

Digestive Health Questionnaire

Hi There,
Please complete the survey below to tell me about your current situation. In the final question, provide your contact details for your FREE 15 minute online consultation. I look forward to chatting with you soon!
In Good Health,
Colette Kent
info@elementshealingandwellbeing.com
www.elementshealingandwellbeing.com
1.What do you enjoy most about your life right now?
2.What are the areas of your life that need some attention?
3.Do you have any digestive issues at present? Please tick the box(es) that apply.
4.With 70-80% of our immunity housed in our digestive system, this can be the source of other physical and mental symptoms in our body and mind. Please tick the box(es) that apply to you.
5.On a scale of 1 to 10 what are the severity of these symptoms? 1=mild 10=very severe (please explain)
6.What are your main concerns/frustrations in your life right now?
7.What worries you - what are you afraid will happen if these concerns/frustrations aren't addressed?
8.What would you like to change in your life right now?
9.If you could have one question answered, what would it be?
10.In order to receive your FREE 15 minute consultation with me to discuss your particular situation, please provide your name and email and I will contact you to schedule our chat!