JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
PrimeMyChakras Program Evaluation
Please fill out your personal information and answer the assessment questions below for your coaching session. Notice: we do not share or sell personal information with third parties.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Date :
*
MM
/
DD
/
YYYY
Name :
*
Your answer
Phone :
*
Your answer
Email :
Your answer
1.
Now that you have completed the PrimeMyChakras program, do you feel you have a stronger foundation and are more grounded?
*
Somewhat
Definately
No
2.
Do you feel you have healthier relationships with others?
*
Somewhat
Definately
No
3.
Do you feel you have a healthier relationship with self?
*
Somewhat
Definately
No
4.
Are you experiencing your heart being more open to giving and receiving love?
*
Somewhat
Definately
No
5.
Are you able to speak your truth with more confidence?
*
Somewhat
Definately
No
6.
Do you feel more comfortable with trusting your intuition?
*
Somewhat
Definately
No
7.
Do you feel you have a stronger faith and connection to All That Is?
*
Somewhat
Definately
No
8.
Has your experience of abundance changed?
*
Your answer
9.
What is your passion and vision for your life moving forward?
*
Your answer
10.
We are seeking testimonials about our program. Please share your overall experience that we could share with others.
*
Your answer
Select Coach and Email
*
1. For Cinda: select cinda@primemychakras. com 2. For Rochel: select infinitelivingnow@gmail. com 3. For Greg: select gmoreyone@yahoo. com
Choose
cinda@primemychakras.com
infinitelivingnow@gmail.com
gmoreyone@yahoo.com
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
