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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?*
Would you like to work with Eléa & Adam live on the meeting?*
- Yes.
- No. But I would like for them to answer my questions / help with my problem.
What Burnout symptoms do you want to eliminate?*
- 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?*
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)*
What are you using to cope / manage stress?*
- 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?*
What's going to happen if you don't fix it?*
What will happen when you DO conquer fatigue & burnout? How will your life be?*
What do you want more than anything else right now?*
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