JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
FREE Holistic Wellness Reading
Includes:
A reading on your Physical, Emotional & Spiritual Wellbeing
A customized Wellness Plan so you can start implementing changes and feeling better right away!
A long-term Wellness Plan option
* Indicates required question
Email
*
Your email
How did you hear about Meraki Wellness, llc
*
Facebook
Instagram
Thumbtack
Personal Referral
Other:
Required
Phone Number
*
Your answer
Preferred method of contact
*
Email
Phone Call
Text
Full Name
*
Your answer
Preferred Name
*
Your answer
Preferred Pronouns
*
Your answer
On a scale of 1-5, how serious are you about your wellness goals?
*
Meh, it's free, so I thought I'd check it out
1
2
3
4
5
SUPER serious. I need support and tools STAT
What is the area you'd like to focus on first/the most?
*
Physical
Emotional
Spiritual
All 3!
Required
Do you have a specific end goal in that area?
*
Yes
No
Required
If yes, what is your specific goal? Otherwise, write N/A
*
Your answer
Why is now the perfect time to work on this area of your wellness/your goal?
*
Your answer
What would be your DREAM results that come with reaching that goal?
*
Your answer
How much time per day are your open to dedicating to that goal?
*
5-30 Minutes
30 - 60 Minutes
60 + Minutes
Time is no object, as long as I reach my goal!
Required
What do you precieve as a challenge to reaching your goal(s)?
*
Your answer
What do you see as an asset to reaching your goals?
*
Your answer
Is there a budget I should be mindful of when creating your plan?
*
Your answer
What else do you feel is important for me to know when creating your custom plan?
*
Your answer
Book Your Reading Here
bit.ly/BookMerakiWellness
Thanks for taking the time to focus on your wellness!
You will receive a Google Meet link 15 minutes prior to your appointment. All Holistic Wellness Readings are held virtually.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Meraki Wellness, llc.
Report Abuse
Forms