On a scale of 1-5, how would you rate your current overall wellness? (1=Poor, 5=Excellent*

Are you currently experiencing any of the following? (Check all that apply)*

How would you describe your current nutrition? (Check any that apply)*

Are you interested in receiving nutrition tips or guidance as part of your wellness journey? (Yes/No)*

How active are you currently? (Check one)*

Are you looking to add more movement or fitness into your routine? (Yes/No)*

On a scale of 1-5, how would you rate your current stress levels? (1=Very Low, 5=Very High)*

Which types of therapies sound interesting to you? (Check all that apply—no pressure!)*