Module 1 Questionnaire

Thank you for taking the time to reflect on the questions included here.
The ILF program poses many questions that can help illuminate where you can look to find the answers to the questions that are demanding attention in your life. The first module will invite you to more deeply appreciate the wisdom of your body and how to access it. You will find questions here that can provide helpful information as to how you may (or may not) be listening to what your body is telling you and how your body can be a tool for deepening your self knowledge.
As we continue through each of the modules, there will be additional (shorter!) questionnaires included on the dedicated website page for each module. Whether you complete the questions and return them to me or simply use them as a stream of “prompts,” they can help you stay engaged with the material from week to week and may even change the answers you give later on in the program.
Please be assured that any information you share with me during the Inspired Life Formula will be kept confidential.

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Name *

First

Last

Email *

What sparked your interest in the Inspired Life Formula Program? *

What specific issues would you like to address? *

How would you describe your life in general? *

How would you define your purpose or meaning in life? *

What aspects of your life are not fulfilling, if any? *

Overall, how optimistic are you about your life? *

How important is it for you to be happy or have peace of mind? *

What goals do you have for your personal or professional life? *

What life challenges are you currently facing? *

How able do you feel to handle these challenges? *

What would you like to be, do or have that's currently missing in your life? *

Do you feel you're at a crossroads or in transition? *

How do you think spirituality or consciousness affects your well being? *

Describe any current spiritual, contemplative or meditation practice you have. *

Are you able to focus or sit in stillness easily? *

In general, is your self feedback supportive or critical, and how so? *

Do you make time in your life to relax, play, re-energize or inspire yourself? *

Are you facing any health challenges? *

How comfortable are you in your body (weight, age, appearance)? *

How would you describe your sleep? *

How well do you take care of yourself by eating in a healthy way? *

How would you describe your energy levels? *

How do you take care of yourself when your energy is depleted? *

Do you take time to rest or relax or just do nothing? *

How frequently and in what way do you exercise? *

If you have health challenges, are you clear about their cause? *

How might your health be affected by psychological, spiritual or emotional reasons? *

What do you do to take care of yourself on a regular basis? *

Is your home environment peaceful, nurturing and meaningful to you? *

Do you feel stronger or more alive in nature? If so, do you make time to be in nature? *

In what ways are you sensitive to the energies of others, to places or activities? *

Please describe any kind of energy work, visualization exercises or mental imagery you've used to set goals or improve your well being. *

Is there anything else you'd like to share about yourself? *

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