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* 1. What health issues do you have, if any?

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* 2. Have you sought professional help for these health issues?

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* 3. How do you feel these health issues impact on the areas of your life as described below?

  Not At All A Little Somewhat Quite A Lot Massively
Career
Social Life
Romantic Relationships
Self-Esteem
General Quality of Life

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* 5. Why do you desire to change your health and wellbeing?

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* 6. What would you consider a successful improvement to your health and wellbeing?

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* 7. What interests and hobbies do you have?

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* 9. What is your gender?

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* 10. Thank you so much for helping me with my research, I really appreciate it! As a thank you for taking the time to complete this survey, I'm offering a free copy of my Top Three Tips to help anyone begin improving their health and wellbeing right now. Just enter your name and best email address in the boxes below, and I will send it over as soon as it's ready, and you can start making amazing changes in your life! :)

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