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Questionnaire
First Name
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What motivated you to sign up for this program?
My Next Brave Step is currently in the form of a:
Hunch
An old goal that I want to revive
A new goal for the future
We’ll see - I’ll come up with it!
What do you hope to get out of this experience?
What prevented you from taking Your Next Brave Step in the past?
Have you participated in a group like this in the past? If so, when?
Things I’ve tried in the past/present:
Therapy
Coaching
Meditation/Mindfulness
This is my first time trying something like this
Other
Please explain
On a Scale of 1-10, where do you see yourself in relation to your Next Brave Step today? 1: Far away; 10: I’m there!
On a Scale of 1-10, where do you hope to be in relation to your Next Brave Step, after completing this workshop? 1: Far away; 10: I’m there!
What types of things do you need to help you get from point A (now) to point B (then) (choose all that apply)
Connecting with others going through a similar process
Guidance and support more one on one
Solitude, alone time
Time and flexibility
Structure and self-assigned deadlines
Clarity to hone in on a specific goal
Open-mind to brainstorm about all the possibilities
Other
Please explain
What types of things get you into your “Flow State” (when everything feels easy, time passes smoothly, and you forget about your to-do list) (choose all that apply)
Physical movement
Stillness
Music, high energy situations
Quiet, solitude
Doing a hands on task
Reading a book
Daydreaming/imagining
Being in nature
Staying cozy inside
Other
Please explain
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