What describes your biggest daily struggle? *

A) I want to care for myself, but just can't start.

B) My mind never stops—constant overthinking.

C) I feel disconnected, like I’ve lost myself.

D) I feel exhausted no matter how much I rest.

*Choose Only One Response

How do you handle relationships and/or social connection? *

A) I put others first, even when it drains me.

B) I overthink what to say or how I'm perceived.

C) I pull away to protect my peace.

D) I stay alert or guarded with others.

*Choose Only One Response

How do you sleep? *

A) I fall asleep drained but wake up just as tired.

B) I cant falling asleep—my mind won’t shut off.

C) I sleep too much or not enough.

D) I wake up often and struggle to feel rested.

*Choose Only One Response

When stress hits, how do you usually cope? *

A) I push through, even when I'm drained.

B) I overthink and replay every detail.

C) I shut down and avoid dealing with things.

D) I'm on edge and can't relax.

*Choose Only One Response

Which do you feel would anchor you after a tough day? *

A) Relaxing space to recharge my energy.

B) Clarity so I can quiet my thoughts.

C) Connection with someone who gets me.

D) Being calm enough to fully relax.

* Choose Only One Response

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Branch of Service *

EOS Year Only (Separated or Retired)

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