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Holiday Food Relief Session
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Name and Email
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Your answer
Why are you interested in a Holiday Food Relief Session with Marla?
Your answer
What is the #1 challenge do you have with your body image?
Your answer
What are you biggest struggles with Food?
Your answer
What is your deepest desire as it pertains to your relationship with food / body?
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Your answer
Have you been diagnosed with an Eating Disorder past or present? If so, please elaborate.
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Your answer
What do you believe is holding you back from having the relationship with your body and food that you desire?
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Your answer
If you have challenges with food, what does it look like? Check all that apply
Restricition and Dieting
Over-eating and/or Binge eating
Food Obsession
Feel guilty about my food
Have no idea what and how to eat
Other:
What are your biggest life's stressors?
Your answer
What kinds of Personal Growth & Spiritual Studies have you done? For example, yoga, therapy....etc.
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Your answer
On a scale of 1-10 how ready are you to invest time, energy and finances to receive support to making lasting change?
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1
2
3
4
5
6
7
8
9
10
How soon would you like to transform the challenges you mentioned above?
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YESTERDAY
It would be great to do this in the next few months.
I am in no rush
I have been trying and I don't think it will ever change.
Other:
If you are selected to receive a session with Marla, what is the #1 thing you'd like to receive from it?
Your answer
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