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There are 7 main areas of your life that we will address in this questionnaire; they are not categorized in any order of importance as this may be different for every individual.


Be instinctual when you answer these questions, do not overanalyze. Some questions may not apply to you, so please leave those blank.


I honor your privacy, if you don’t feel comfortable answering any of the questions please write “not comfortable”.

Please make sure to fill out all 7 sections.

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