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If anything was possible where would you like to be five years from now?
   
 
 
 
How well do you sleep at night?
 
Poor
 
Below Average
 
Average
 
Good
 
Excellent
 
 
 
Do you feel that you are in control of your emotions? Please explain.
   
 
 
 
Have you ever thought about starting a business? Is this something you would like to do in the future?
   
 
 
 
What is your creative outlet? Example: music, art and etc.
   
 
 
 
Is there anything you would change about your social life? Are you happy with your personal relationships?
   
 
 
 
How often do you work out? What type of exercise do you enjoy?
   
 
 
 
How do you feel about your spiritual life?
   
 
 
 
How do you feel about your career?
   
 
 
 
Have you ever thought about going back to school or pursuing a new skill?
   
 
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