📝 Onboarding Intake

Full Name

Email *

Phone *

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Instructions: Please rate each question on a scale of 0–10
(0 = not at all, 10 = constantly/completely).

How often do you feel physically comfortable, energized, and free to enjoy your daily activities? (0–10)

How often do you experience calm, focus, emotional stability, and restful sleep? (0-10)

On a scale of 0–10, how much stress have you experienced in your relationships, work/finances, health, or daily challenges in the past week? (0-10)

How regularly do you feel relaxed, confident, connected, joyful, and satisfied with your life overall? (0–10)

How adaptable and resilient do you feel in responding to stress and changes in your daily life? (0–10)

What do you want to accomplish over the next 90 days together and within the community?

What would this program being truly valuable look like for you?

How do you usually handle stress when you experience it?

What have you done in the past to accomplish the above? (If you’ve never attempted, put “N/A.”)

Are you prepared to show up for yourself and get the most out of this program?