Your Lifestyle Check-In

This check-in is designed to help you pause, reflect, and identify lifestyle pillars that might need attention and focus. It is your starting point for building a personalized wellness path that guides long-term balance.

Please answer the following questions to gauge your current state of well-being.

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How is your sleep?

I have difficulty falling asleep

I have difficulty staying asleep

I have difficulty waking up and feeling groggy

I am not experiencing sleep difficulties

How is your digestion?

I've had more gas, bloating or constipation

I've had acid reflux or indigestion

I've felt very full after eating for an extended time

My digestion feels normal

How is your skin/body?

I have been experiencing dry skin, dry eyes, or dry mouth.

I have been experiencing red, itchy, or irritated skin.

I have felt very hot or am experiencing hot flashes.

I have had fluid retention in the tissues or congestion.

I have had some weight gain or am above my ideal weight.

I have been feeling sore and not moving well

I feel balanced in my body

How is your current mind state?

I have been scattered and distracted.

I have felt anxious or excessively worried.

I have been obsessively focused on work, exercise, or other projects.

I have felt irritable, frustrated, or impatient.

I have been unmotivated and procrastinating.

I have felt like withdrawing and not dealing with life

I have been feeling peaceful, focused and balanced in my mind.

How is your energy?

I have been feeling physically ungrounded

I have been feeling restless

I have been feeling depleted and fatigued

I have been having adequate energy to fuel my day.

Do you eat most of your meals warm and cooked or do you eat mostly cold/raw salads or smoothies?

Do you have a consistent bedtime and wake-up time, even on weekends?

Do you take time for slow, gentle movement (like walking or restorative yoga) at least 3 times a week?

Do you regularly apply oil to your skin (such as after a shower or before bed)?

Do you practice a daily moment of quiet (meditation, breathwork) for 5 minutes or more?

Your answers above will help us understand where your current imbalances lie. Now, let’s look ahead.

If you could choose ONE area to see significant improvement in the next 30 days, what would it be?

* Example: Deeper sleep, calmer mind, softer skin, less physical tension.

In one sentence, describe how achieving this goal would change your daily life:

Begin Your Personalized Path

Your answers provide valuable insight into the state of your inner balance. We can help translate this information into an effective, personalized plan using integrative bodywork, holistic skincare, and Ayurvedic education.

Choose the path that feels right for you today and request a discovery call. We'll discuss your check-in results and collaboratively create a customized treatment plan during a 15 minute consultation.

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