My Life right now!

Sometimes 2 minutes of reflection reveals so much about WHERE we are right now! On a scale of 10, rate the following areas of your life.

Name *

First

Last

Phone *

Email *

Gender *

Date of Birth *

25/02/2000

How would you rate "FAMILY" in your life right now?

Selected Value: 5

How would you rate "FUN" in your life right now?

Selected Value: 5

How would you rate your "HEALTH" right now?

Selected Value: 5

How would you rate "LOVE" in your life right now?

Selected Value: 5

How would you rate "SPIRITUALITY" in your life right now?

Selected Value: 5

How would you rate your "CAREER" right now?

Selected Value: 5

How would you rate "MONEY" in your life right now?

Selected Value: 5

How would you rate "FRIENDS" in your life right now?

Selected Value: 5

What would you like to "IMPROVE" in your life right now? *

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