Engagement

What makes you feel like you're "in the zone"? *

When was the last time you felt that way (at work or at home)? *

What maks you feel overworked or overwhelmed? *

Is there a payoff or benefit to overcommitting to those things that make you feel overworked? *

Yes No

What would ideally improve your focus AND calm of mind at work? *

What is the #1 thing that distracts you at work? *

Rate from 1 to 5 how distracting this is to your work? (1 = least distracting, 5 = most distracting) *

What else, in general, distracts you at work? *

Do you pace yourself by building in regular breaks from work? *

Yes No

Do you regularly take time to step back to define or redefine what needs to be done? *

Yes No

Do you ever feel guilty when you take breaks or leave early? *

Yes No

Do you give others your full presence and attention in meetings and conversations? *

Yes No

If you answered "No" to the last question, what affects your level of attention? *

On average, what time do you typically get to work? *

On average, what time do you typically leave work? *

In the past year, have you experienced the scope of your job get a lot bigger? *

Yes No Not a lot, but a little

In the past year, has the performance bar become significantly higher? *

Yes No Not a lot, but a little

Which 3 topics below would you be most interested in learning more about? (Pick 3) *

Mindfulness Training (improving attention, being more focused) Stress Reduction (finding an "off" switch, reducing anxiety) Productivity (increasing output, avoiding burnout) Decision-Making (thinking clearly, choosing consciously) Resilience (bouncing back, reacting less) Self-Awareness (situational awareness, greater balance) Creativity (overcoming blocks, thinking insightfully) Leadership Training (communicating effectively, improving EQ)

How interested are you in INDIVIDUALIZED 1-ON-1 PHONE COACHING in the areas you selected above? *

Not Interested Somewhat Interested Very Interested Extremely Interested

How interested are you in ONSITE GROUP TRAINING for the areas you selected above? *

Not Interested Somewhat Interested Very Interested Extremely Interested

What difference would consistently showing up at your best make to the outcomes you hope for at work and at home? *

Engagement, Mindfulness & Fulfillment

General Information

Skill & Capacity

Focus & Productivity

Fitness & Attention

Work Hours

Scope & Performance

Training & Development