In a couple words, how would you describe your feelings about starting your work day?

 
How do productive to you feel your work days are?

 
How many social media accounts do you manage?

Facebook, Twitter, Snapchat, Instagram, YouTube, anything that lets you comment or reply

 
Do you use anything to organize your social media?


 
Including work and personal usage, how much time do you think you spend on social media each day?


 
Does your work require you to be on social media?


 
At night, do you go on social media right before you go to bed?


 
Does your work affect your personal relationships?


 
Would you like your work hours to...


 
Do you feel like you understand your work tasks and projects?


 
Do you volunteer in any capacity? Include anything that you don't get paid for that benefits others outside your home.


 
Do you regularly have time for your interests and hobbies outside of work?


 
Do you work on days of the week that you have off?


 
Do you mediate, exercise or take scheduled offline time?


 
Are you currently in counseling or therapy?

I will never ask you why you are going but would like to know if you have additional support.

 
Do you consider yourself physically healthy?


 
What was the last successful healthy habit you formed and what helped make it stick?

 
Are you ready to change your work habits?


 
Are you interested in tackling multiple new habits?


 
What is your first and last name?

 
Would you also like to join the Beneficial Habits email list? I will be sending it about once a month.

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What is the best phone number to reach you for our coaching calls (if interested)?

 
How did you hear about Beneficial Habits?

This could earn you a discount :)
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