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Live Q&A with Eléa Faucheron & Adam Von Ins
Please fill out the form below so we can prepare for working with you during the advanced workshop.
Live Q&A With Eléa & Adam
Name
*
First
Last
Best Email (please use the same one you will sign into our Zoom meeting with)
*
What’s your occupation?
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Would you like to work with Eléa & Adam live on the meeting?
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Yes.
No. But I would like for them to answer my questions / help with my problem.
What Burnout symptoms do you want to eliminate?
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Anxiety
Fatigue
Depression
Overwhelm
Anger
Shame
Guilt
Frustration
Resentment
Fear
Poor Sleep
Weight Gain
Decreased Appetite / Weight Loss
Dizziness
Nausea
Headaches / Migraines
Stomach Problems
Tension
Chest pains
Trembling
Hair loss
Thirsty
High Blood Pressure
Low Sex Drive
Frequent urination
Suicidal Thoughts
Other
How many hours daily, on average, of energetic free time would you like to have?
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Please enter a number from
0
to
24
.
What question / problem do you want us to help with in turning Fatigue & Burnout into more free time & energy? (don't be shy, the more you share, the more we can help)
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What are you using to cope / manage stress?
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Medications (i.e. SSRI's, Anti-Anxiety Meds)
Therapy / Counseling
Exercise
Supplements
Meditation
Self-Help Books / Programs
Over Working
Stress Eating
Binge Shopping / Spending Money
Drinking
Smoking
Eating Out Too Much
Technology (i.e. too much Candy Crush)
Marijuana
Pain Pills
Other
None of these
What have you tried to fix things that has not worked?
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What's going to happen if you don't fix it?
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What will happen when you DO conquer fatigue & burnout? How will your life be?
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What do you want more than anything else right now?
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Phone
This field is for validation purposes and should be left unchanged.
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