What is happening in your life that is prompting you to reach out at this time?
How long have you struggled?
What negative thoughts and feelings are you experiencing?
What are you currently doing in your life? What does a typical day look like?
If you are married or in a relationship please describe the relationship:
Do you have children? If so, list them and their ages
Who in your life are struggling with right now and why?
Describe your parents relationship. (both past and present) What did you and didn't you like?
Do you have siblings and how are those relationships?
What was your childhood like growing up?
What are some of your favorite and most painful memories?
What traumas have you experienced as a child, teen, and adult? Try to differentiate.
How have these traumas affected you now?
What therapy, self-help, or medications have you tried?
Do you eat healthy and if not, what is stopping you?
What is your sleep schedule/routine like?
How often do you exercise and move your body?
How do you deal with your emotions now?
Do you have a spiritual connection? If yes, what does that look like and how do you nurture it?
On a scale from 1-5, what is your current level of satisfaction with what you are doing in your life and how you are living? (5 highest) Select... 1 2 3 4 5
Do you feel that you are aligned with your true self and purpose?
Are you aware of what your passions are and if yes, what are they?
Are you aware of what your unique gifts or talents are. If yes, what are they?
What feelings are you having right now with how your life is and the direction you are heading?
What have the consequences been in your life when you haven’t lived authentically and purposefully? (Example: Feeling stuck or as if you are missing out on your life; Experiencing depression, anxiety, or frustration. Realizing life is too short.)
What is your level of commitment to finding health and happiness? Are you willing to work? (Scale 1-5) Select... 1 2 3 4 5
If you answered 1 to 3 in the last question, what is more important in your life right now than pursuing happiness?
Who in your life is supporting you right now?
If time, money, and fear weren't in your way, what would be happening in your life?
What is more important right now than your happiness?
What do you feel is blocking you from living happily and authentically? (ex: I am lost, no support, no time, no money, afraid to fail, etc)
If you don’t have support right now, how do you think having support would help you pursue your dreams?