Interactive Sleep Coaching
Stage 1 - FREE Evaluation - General Questions
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Meditate or Medicate?
the Spirit of Sleep can help you with your choice.
They come in all shapes and sizes
This e-book:
The Spirit of Sleep will be your guide, but it is your personal experiences, your situation, that will be the focus of your attention.
The Spirit of Sleep will provide the necessary tools, but is your implementation of the tools that will direct your change.
The Spirit of Sleep will encourage your participation, but it is you who must embrace the first step.
The Spirit of Sleep Interactive Sleep Coaching program will offer successful strategies to reduce your insomnia and improve your sleep. Get started with your FREE Sleep Evaluation now!
Any questions asked at any time during the Sleep Coaching program are not intended to invade your privacy, but rather are intended to provide an overview or ‘snapshot’ of aspects of your life that could be negatively affecting your sleep. Except entering General Information, if you are uncomfortable at any time, with any of the questions, then please do not answer them.
General Information:
Sleep Challenge/Issues:
1. Please explain what type of sleep challenges are you dealing with?
2. If this is ‘insomnia’, is it the ‘can’t get to sleep at the beginning of the night’ or the ‘wake up in the middle of the night’ variety?
3. How long has this sleep problem existed?
Medications/Sleep Aids
(With these questions, I am not asking which medications you are taking, but rather just to gather general information about medications that may be affecting the quality of your sleep.)
1. Do you take any prescription sleep medications?
2. Do you take any over-the-counter (drug store) variety of sleep aid?
3. If the answer is YES to either of the above, do you find them effective?
4 Are you currently under a medical doctor’s care for your sleep problems?
5 Are you currently taking any other medications for any other conditions that may be interfering negatively with your sleep?
6. What, if any alternative/holistic techniques/tools/activities have you tried to help improve your sleep?
Life Style
1. Do you work, are you retired or semi-retired?
2. If you are currently employed, in general, what type of work do you do?
3. What are your leisure time activities?
Living Environment
1. What are the circumstances of your living environment?
If you live within a family structure, how many members does your household consist of?
2. Would you describe your household as basically calm or very active? In other words, do you have an opportunity for privacy particularly late in the day or early evening?
Your Snapshot
1. Have you had any major changes or trauma in your life recently, or that you’ve been dealing with on an ongoing basis that could be negatively affecting the quality of your sleep?
2. In a few sentences, generally describe what a typical night (of trying to sleep) is like for you.
3. In a few sentences, generally describe what a typical day is like for you.
Goals and Expectations
1. What are your goals or expectations of this Sleep Coaching program? Do you have specifics intentions that you wish/expect to achieve?
Upon receipt of this questionnaire, Glenda will contact you.
2. What time of day is best for Glenda to contact you?
Disclaimer - Please Read and Accept
Name:
Phone #:
Primary Email Address:
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30 Days to more Peaceful Sleep!
3. What is your level of interest in overcoming your sleep challenges through this Interactive Sleep Coaching Program?
4. Would you like to proceed to the next step - the complimentary initial discussion?
