Pre-Course Survey: The Mindful Body

How do I currently feel about my physical health (diet, exercise, weight)?(Required)

5 - Totally Satisfied

4 - Somewhat Satisfied

3 - Neutral

2 - Somewhat Dissatisfied

1 - Very Dissatisfied

What would I specifically like to improve through this program in regards to my physical health?(Required)

If there were one statement that encapsulated how I feel about my body today, it would be:(Required)

How do I currently feel about my mental health (anxiety, depression, stress levels)?(Required)

5 - Totally Satisfied

4 - Somewhat Satisfied

3 - Neutral

2 - Somewhat Dissatisfied

1 - Very Dissatisfied

What would I specifically like to improve through this program in regards to my mental health?(Required)

What do I see as the connection between my mind and body today, if any?(Required)

How do I currently feel about my emotional health (ability to feel emotion, name emotions, and move through emotions in healthy ways)?(Required)

5 - Totally Satisfied

4 - Somewhat Satisfied

3 - Neutral

2 - Somewhat Dissatisfied

1 - Very Dissatisfied

What would I specifically like to improve through this program in regards to my emotional health?(Required)

What do I see as the connection between my emotions and my body today, if any?(Required)

How do I currently feel about my spiritual health (level of connection to something Higher or Greater than myself)?(Required)

5 - Totally Satisfied

4 - Somewhat Satisfied

3 - Neutral

2 - Somewhat Dissatisfied

1 - Very Dissatisfied

What would I specifically like to improve through this program in regards to my spiritual health?(Required)

What do I see as the connection between my spirit and body today, if any?(Required)

How do I currently feel about the health of my close relationships? (with my life partner, family members, or friends)(Required)

5 - Totally Satisfied

4 - Somewhat Satisfied

3 - Neutral

2 - Somewhat Dissatisfied

1 - Very Dissatisfied

What would I specifically like to improve through this program in regards to my relationships?(Required)

What do I see as the connection between my relationship with others and my relationship with my body, if any?(Required)