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Total Wellness Empowerment Survey

Total Wellness Survey

Participant Information

Today's Date: *

First & Last Name *

Email Address:

Phone Number: *

Total Wellness Empowerment

Where are you now in your lifestyle empowerment journey? *

Do you actively review your goals on an ongoing or periodic basis? *

What are your 3 top personal or total wellness goals? *

Feel free to get creative on ideas on inspiration 

What is your biggest struggle to accomplishing your life goals for success? *

Examples can range from limited resources, extensive overhead, limited opportunities, no support system, unstable living conditions, unstable work

Have you established a will, trust or estate? *

Do you have a family attorney, lawyer or designated support for legal protection ? *

Do any of the following apply to you? *

How long have you been in your current career field or business? *

Are you looking for new career opportunities in the same industry or looking to expand and get new skills and certifications? *

Do you have passion for any of the following? *

Financial Empowerment

What does financial empowerment mean to you? *

What are your 3 top financial goals? *

Do any of the following apply to you as an individual? *

If so what industries, areas or client markets do you serve? *

How long have you been in business? *

Do you have a: *

What goals are you looking to accomplish in your business? *

Do you suffer from challenged credit? *

Have you recently or in the past undergone credit repair? *

Do you know your credit score ? *

Are you open to fast-track  business opportunities ? *

Have you considered business succession planning? Ex: Who will inherit your business in the future? *

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