Self Discovery Questionnaire

Self Discovery Questionnaire

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Self Discovery Questionnaire
  • SOUL SERENITY AND DIVINE WELLNESS RETREAT

    SELF DISCOVERY QUESTIONNAIRE

  • To receive the highest benefit of your self-discovery immersion, give yourself an uninterrupted 1 hr to answer the following questions. Find a private space where you will be relaxed and you won't be distracted...phone should be off. Let go of your to-do list and any person, place, or thing that takes you away from YOU. If you need some help relaxing, here are a few suggestions... a ten minute meditation, listen to Moonlight Sonata by Beethoven, or if it serves you better... wild and crazy dancing to release some tension.

    Keep a journal or a notebook. Be mindful as you answer the questions on how your body responds. You may feel nothing or you may feel something... If so, where? Are emotions coming up for you? If you feel uneasy, note where in your body you feel it.

    If you need to take a break, do not worry as you will be able to stop and go back to the questions at your convenience. If you have any issues completing the questionnaire online. Please send me a text to let me know. Thank you

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  • LIFESTYLE

    Check all the factors that apply:
  •   Yes No
    Fast eater
    Erratic eating habit
    Eat to live
    Live to eat
    Late-night eating
    Family contradicts my eating habits
    Rely on fast food
    Negative relationship with food
    Emotional eater
    Time constraint
    Poor snack choices
    Travel frequently
  •   Yes No
    Vegan
    Vegetarian
    Macrobiotic
    Organic
    Raw food
    High protein
    Gluten-free
    Gluten/casein free
    Allergies (list all allergies below)
    Sensitivities (list all sensitivities below)
  • EXERCISE

  •   Type/Intensity (low/mod/high) # Day Per Week Duration (mins)
    Stretching/Yoga
    Cardio/Aerobics
    Strength Training
    Sports or Leisure
    Dancing
    Walking
    Other
  •   TRUE FALSE MAYBE SO
    I don't have to see healing to believe it exists
    I can alter my genes by how I think
    My body has the innate ability to heal itself
    My body responds to my emotions~when they change, so does my body
    I have healed myself at least once
    I've used herbal and/or aromatherapy remedies that were effective
    My thoughts and speech are more positive than negative
    Everything happens for a reason
    I care what others think about me
    I would most likely speak up vs. going along with the crowd
    I have the tendency to procrastinate or give up on things
    I feel confident in trusting my intuition
    I am conscious of living in the present most of the time
    I live mostly in the past or the future
    I am judgemental and/or critical
    I feel that I am truly blessed
    I easily forgive others
    I easily forgive myself
    I don't hold grudges
    I believe in miracles
    I am the creator of my own reality
    Gratitude creates positive change in my life
    Do I believe in Angels, Guides and Masters
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