PFW Questionnaire 2020

QUESTIONNAIRE

Date *

* Indicates required field

Name *

First

Last

Email *

Skype Handle if you have one (we can also use Zoom or Facebook Messenger to meet) *

How did you hear about me? *

If on Facebook, please check all that apply *

Through an ad On a friend's wall In a group Continuum Concept related

If in a Facebook group, which one? *

What country/state/province do you live in? *

Names and ages of your children *

Please tell me about yourself and your family *

What are your current circumstances (if different from above) during these unique times? *

What are the top 3 challenges you're experiencing in your family? *

What would you love to be able to live over the next weeks/months? *

What is in your way of living this vision? *

One a scale of 1 to 10 (10 being highest,) how committed are you to achieving this vision? *

What would you like to receive from this 30 minute session? What would you like to leave equipped with? *

Is there anything else you'd like me to know? *

Submit

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