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Coaching Enquiry

Hi, this questionnaire will help me create a program for you and begin our conversation around helping you feel better.

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Question 1 of 8

What brought you here? What would you like to improve?

Question 2 of 8

How did you find Tiny House Ayurveda? Please list any of our health programs, courses or free workshops that you've done.

Question 3 of 8

Please list any clinical health conditions you have and any prescription medications you take.

Question 4 of 8

Please list any supplements you regularly take and whether they are self-prescribed or were recommended by a health professional.

Question 5 of 8

Please list how much money you spend on medications, supplements and visits to health professionals on average a month?  

Question 6 of 8

Are you looking after anyone else?

A

Yes

B

No

Question 7 of 8

Are you pregnant or lactating?

A

Yes

B

No

Question 8 of 8

How much time do you spend on your wellbeing a week eg:exercise time, visits to Yoga studios or health clinics, scheduled time out for play and rest and meal preparation - please list. Dig deep for this one!

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